ABSTRACT
CASE 8.1 – Heavy drinking A 49-year-old bricklayer attended his general practitioner (GP) after experiencing an epileptic seizure. Approximately 5 years previously he had noticed that his hands were shaky in the morning. This would last until lunchtime, when he would drink five or six pints of beer in the pub with his work colleagues. At this point the shakiness would settle and he would feel much better. His daily intake of beer had gradually increased over several years, and he always kept an alcoholic drink beside the bed to have when he woke up to ‘steady his nerves for the day ahead’. He had noticed some numbness in both feet, and had brought up some fresh blood while retching. His friends commented that his memory was poor, and he wondered whether his skin might have a yellowish tinge to it.
