Korsakoff's psychosis

This woman is clearly at high risk of alcohol-related disease as she has a high-risk profession and abnormal blood tests.
The fact that she seems to be confabulating makes Korsakoff's the best diagnosis. She has no evidence of nystagmus or ataxia suggestive of Wernicke's encephalopathy. Subdural haematoma is usually easily diagnosed by CT scan. Alcohol withdrawal usually occurs 48-72 hours after the last alcoholic drink (and we do not have any timings here).

Do not forget to exclude hypoglycaemia, hyponatraemia and hypomagnesaemia as causes of fits in alcoholics.

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