Pontine Warning Syndrome in a 102-Year-Old Independent Woman: A Rare Cause of Recurrent Fluctuating Neurological Deficits.

Pontine warning syndrome describes recurrent, transient neurological episodes arising from pontine pathology and carries a high risk of subsequent infarction. We report the case of a 102-year-old woman who presented with repeated, stereotyped episodes of unilateral weakness and dysarthria before developing a confirmed pontine infarct. Early CT imaging was normal, and the diagnosis was established only after MRI demonstrated an acute brainstem lesion. Her clinical course reflects previously described patterns of fluctuating deficits linked to pontine perforator disease, intermittent hypoperfusion, and sensitivity to blood pressure changes. She was treated with dual antiplatelet therapy and made a complete recovery. This case highlights the importance of recognising pontine warning syndrome promptly, as early localisation guides imaging strategy, monitoring, and management.