Dear editor, A 75-year-old woman with past medical history significant for hyperlipidemia, glaucoma, and breast cancer status-post lumpectomy and radiation in the distant past presented with 72 h of declining mental status. Her symptoms were notable for progressively worsening hypersomnia that resulted in her husband needing to wake her after 14 h of sleep on the day of presentation. Additionally, the patient displayed apraxia with inability to dress herself and had an episode of fecal incontinence. At baseline, the patient was reported to be a high-functioning individual, who was able to accomplish her activities of daily living independently. She resided in Martha’s Vineyard with her husband and had traveled to Boston 1 day prior to symptom onset. On presentation, the patient was afebrile and hemodynamically stable. Her physical exam, including an extensive neurological exam, revealed that she was oriented to self, but not to place or time. She also exhibited short-term memory loss evidenced by her inability to recall information provided to her just minutes prior. The rest of the exam was unremarkable.