Wernicke encephalopathy (WE) is a neurological emergency that develops in the setting of thiamine deficiency, and is characterised by symptoms of confusion, ophthalmoplegia and gait ataxia. Less recognised signs and symptoms include vestibular dysfunction, hearing impairment, peripheral neuropathy, and in severe cases, coma. This case study describes a non‐alcoholic patient, who presents with significant auditory and vestibular changes in addition to the classic symptoms of WE. This case report describes a non‐alcoholic patient who developed deafness, severe horizontal canal paresis and symptoms of palinacousis in the setting of WE as a complication of a recent gastric sleeve operation.