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Hearing loss in Wernicke encephalopathy.

A 61-year-old woman presented with acute bilateral hearing loss followed by vague but acute visual disturbances, nonvertiginous dizziness, and confusion. She also reported a recent 40-pound weight loss and 1 month of persistent nausea and vomiting, all of which were attributed to diabetic gastroparesis; an extensive gastrointestinal evaluation (CT abdomen, gastric emptying study, esophagogastroduodenoscopy, and colonoscopy) was unremarkable. Medical history was notable for atrial fibrillation, diabetes mellitus, obesity, osteoarthritis, recurrent Clostridium difficile colitis, and pulmonary embolism.