We report a 55 year old female who presented to us with history of sudden onset of vertigo, vomiting and ataxia for 2 days duration. Patient is a known hypertensive on regular treatment for last 7 years. She was also a recently detected to have diabetes. There was no past history of myocardial infarction or TIA or stroke. Patient is on amlodipine, ramipril and metformin regularly. Patient was admitted and on examination had bilateral gaze evoked nystagmus. She had bilateral finger nose incoordination and gait ataxia. There was no long tract signs to suggest involvement of brainstem. Her peripheral pulses were felt and were in regular rhythm. Clinically cardiovascular system was normal.