Pendular nystagmus showing involvement of the floccular lobes in an atypical case of Wernicke encephalopathy: MRI findings

A 78-year-old non-alcoholic man with acute alteration in consciousness and pendular nystagmus progressed to a comatose state. Recent medical history was significant for a 2-week period of severe vomiting and diarrhoea. Past medical history included diabetes mellitus and Helicobacter pylori duodenal peptic ulcer disease. Axial fluid-attenuated inversion recovery MRI evaluation showed abnormalities of the prepositus hypoglossal nuclei, medial vestibular nuclei, floccular lobes, cerebellar vermis, tectum of the midbrain, periaqueductal gray matter, mamillary bodies, thalami, anterior fornices and motor …