New England Journal of Medicine Vol 356: 612-620
A 56-year-old woman was admitted to the hospital because ofrapidly progressive vertigo and ataxia.
The patient had been well until approximately 10 weeks beforeadmission, when occasional dizziness and nausea occurred, followedduring the next several weeks by increasing positional vertigoand severe vomiting. Antiemetic agents were administered, thevomiting resolved, and her dizziness improved. Shortly thereafter,slurred speech, rapidly progressive ataxia, and difficulty withambulation developed.