[Pontine warning syndrome is a rare sign of ischaemic stroke]

Timely identification of even uncommon presentations of stroke is essential in order to begin effective treatment. In this case report, a 64-year-old male with known COPD, smoking and alcohol abuse developed three stereotyped episodes of dysarthria and left hemiparesis. He was treated with dual antiplatelet therapy and IV thrombolysis which was associated with a termination of symptom fluctuation. MRI showed ischaemic changes in the right pons and the ultimate diagnosis was pontine ischaemic stroke following pontine warning syndrome.