Martini Memories
A 46-year-old alcoholic man had been admitted
to another hospital for pneumonia and delirium
tremens. Both of these were treated successfully in the usual way. But,
following discharge, he failed to return to his usual mental state, at least
according to his family's assessment. He was transferred back to the hospital
for further neurologic evaluation.
On examination at admission, he was awake and
alert with normal speech. His remote memory was intact, but recent memory was
so severely impaired that he was unable to remember the name of 1 object for
15 seconds. He was slightly concrete
in his interpretation of similarities and proverbs and was disoriented to time
and place, but his bedside mental status examination was otherwise normal. There
was slight horizontal nystagmus
on extremes of lateral gaze bilaterally, the stance and gait were slightly wide-based,
and he was unable to walk heel to toe along a straight line. The remainder of
the examination was normal.