Burning oral and mid-facial pain in ventral pontine infarction.

The symptom of burning orofacial pain may help to identify the site of ischaemia in otherwise pure motor strokes resulting from infarction of the ventral pons. A patient with hemiplegia due to ventral pontine infarction, in whom burning oral and mid-facial pain was a prominent initial symptom, is described. Similar pain preceded transient episodes of the 'locked-in' state. Awareness of this herald symptom may permit early recognition and careful monitoring of patients at risk of progressing to the 'locked-in' state.