Case 3
A 65-year-old gardener was brought by his wife to the outpatient clinic. She was
concerned about his poor memory. He was able to give some details regarding
his early life, although these were chronologically inaccurate, but he could
remember nothing at all about the preceding 4 months. He was able to retain
new information for a few minutes but then forgot it. His knowledge of current
events was very poor.
Four months earlier, he had been admitted by the orthopaedic surgeons following
a fractured elbow sustained when he had fallen downstairs. He was
operated on later that day and 4 days after admission, he had been noted to be
more confused and was thought to be hallucinating. On examination, absent
ankle jerks and unsteady gait were found. The following day he had a seizure.
His serum sodium was low at 125mm/L but normalized after fluid restriction.