<prompt> A 45 year old Alcoholic comes to OPD who is on abstinence since last 10 years.He suddenly develops dysahria, shuffling gait and intention tremors . What shall be the most likely diagnosis ?Wilson diseaseWernickes diseaseAcquired hepatocerebral degenerationHalloverden spatz disease  <response>: Disease Features Wilsons ds -Patient will be present at 10 yr age -KF Ring -But here it is alcoholic so ruled out. Wernickes disease -Global confusion, -Ophthalmoplegia -Ataxia Hepatocerebral degeneration -Rare complication of cirrhosis -Indicates a decompensation in of cirrhosis - Development of Poal HTN - develops poosystemic collateral circulation- Ammonia NH3 in circulation - Neurological cf. Halloverden spatz diseaseNBIA -Degeneration due to iron deposition -Accumulation of iron in putamen Presentation is in childhood 10-15 yr. age It is dd of Wilsons disease -MRI iron deposition in putamen given eye of tiger appearance. 