ABSTRACT
A 55-year-old man has been brought into the emergency department by his wife because he has been deteriorating over the last three months. Initially she noticed him becoming confused and forgetful. Then he started to become unsteady and uncoordinated. He developed problems with walking and now has trouble swallowing, has slurred speech, very slow movements and occasional jerks. He smokes about 15 cigarettes per day and drinks a glass of wine most days with his meal. He is not on regular medications. There is no family history of similar problems.
