Case Presentation: 5 59-year-old male with alcoholic cirrhosis, hypertension, COPD, and diabetes mellitus presented with a 3-month history of progressive confusion and altered mental status. His family reported memory decline, prompting multiple ER visits primarily focused on cirrhosis-related complications, overlooking the neurological symptoms’ etiology. Initial improvement following hepatic encephalopathy treatment was short-lived, leading to rapid [...]