Wernickes encephalopathy with central pontine myelinolysis presenting with hypothermia

A male alcoholic who presented with hypothermia and confusion was diagnosed as suffering from Wernicke's encephalopathy. He showed in addition signs of bulbar damage with cranial nerve signs, weakness of all limbs and absent oculo-vestibular responses. His course was complicated by recurrent episodes of aspiration pneumonia with death resulting from this cause. Neuropathological findings included typical features of Wernicke's encephalopathy as well as central pontine myelinolysis.