Clinical Reasoning: A 72-year-old man with a progressive cognitive and cerebellar syndrome

A 72-year-old right-handed man was referred to the cognitive neurology clinic after being involuntarily committed to an inpatient psychiatry unit for 2 years. He was unable to give a coherent history, which was obtained from his wife. His birth and early development were unremarkable. He had previously held a number of jobs including working in the merchant navy for 2 years. He was unemployed before admission. He did not drink alcohol excessively and was a heavy smoker. He was fit and medically well until 5 years before the assessment, when he developed progressive balance and behavioral problems. This included an ataxic gait requiring intermittent wheelchair use, slurred speech, and poor memory. He had become increasingly irritable and aggressive with paranoid ideas of spousal infidelity.

from Neurology recent issues https://ift.tt/36lGNBa