20th July 2023

A 61-year-old man presents with his partner due to concerns about memory loss for the past year.

A 61-year-old man presents with his partner due to concerns about memory loss for the past year. Alongside this, the patient has been unsteady on his feet. You ask the patient questions regarding their history. However his answers are very bizarre and do not relate at all to the question asked.

He has a past medical history of hypertension, gout, diabetes mellitus and previous subdural haematoma. He is a current smoker and has a history of alcohol excess, he currently drinks ten cans of super-strength cider per day.

On examination, he appears thin with generally reduced muscle mass. He has nystagmus and bilateral sixth nerve palsies. As he leaves the room, you notice he has an ataxic gait.

What is the most likely cause of his confusion?

Select the SINGLE most appropriate option from the list below. Select ONE option only.