Abstract
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You visit a 48-year-old patient at home. Her partner mentions that she has been very sleepy over the past week. She has been very well before this. She doesn’t drink any alcohol or take any drugs. Her only past medical history is bariatric surgery a few months ago. On examination, she is apyrexial. Her random blood sugar is 7.8 mmol/L. She is confused and disorientated in time, place and person. She has an ataxic gait. Her pupils are equal and reactive to light. She has vertical nystagmus with lateral rectus palsy on eye examination.
Administration of high dose parenteral thiamine Administration of intravenous empirical antibiotics Administration of subcutaneous dalteparin Administration of subcutaneous glucagon
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