The Case of the Bright Splenium

Altered mental status is a frequent reason for consult for neurology and psychiatry services. Multiple causes can be considered including: Wernicke’s, hepatic encephalopathy, metronidazole-induced encephalopathy, and acute demyelination. We present the case of a 49-year-old Hispanic female with end stage liver disease admitted for altered mental status. Neurology and Psychiatry were consulted.