Case Presentation: A 51-year-old male with previous left-sided cerebellar ischemic stroke and NASH cirrhosis complicated by hepatic encephalopathy presented with 3 weeks of slowed speech, bradykinesia, abnormal facial movements (grimacing, lip smacking, tongue protrusion, and forced eye closure), and confusion. He denied alcohol or other drug use. On presentation, vitals were normal. He was oriented [...]