Case Presentation A 34-year-old woman with no significant past medical history and no history of alcohol or substance use presented with progressively worsening neurological symptoms. Her initial presentation was characterized by dizziness, unsteady gait, blurred vision, and cognitive impairment, including poor concentration and memory difficulties.
Over the preceding three days, her condition further deteriorated with the onset of confusion and slowed responses. History of Present Illness Symptoms present for 10 days, gradually worsening No history of: Fever Headache Seizures Focal neurological deficits Recent infection Relevant Dietary History Prolonged intermittent fasting for 4 months Fasting periods of 48–72 hours weekly Minimal caloric intake on non-fasting days Approximate 18 kg weight loss Poor dietary diversity and lack of vitamin supplementation General Examination Afebrile…
