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“Salt and Pepper” Pontine Infarct

Lyons, Lance J. BA; Law, Susan W. DO; Kubie, John L. PhD

doi: 10.1097/WNO.0000000000000437
Clinical Observation

Abstract: A paramedian pontine stroke may herald the unique symptom of “salt and pepper” eye pain, in which patients describe the sensation of pepper rubbed into the eye. While localization of the lesion is a common thread among published cases, the mechanism for the sensation of eye pain is still a matter of conjecture. It is important for clinicians to be aware of this unique symptom because strokes rarely present with eye pain and failure to establish this diagnosis might lead to a poor clinical outcome.

SUNY Downstate College of Medicine (LJL), Brooklyn, New York; Department of Neurology and Stroke Center (SWL), SUNY Downstate Medical Center, Brooklyn, New York; Department of Cell Biology (JLK), SUNY Downstate Medical Center, Brooklyn, New York.

Address correspondence to Lance J. Lyons, BA, SUNY Downstate Health Science Center, 222 Lenox Road, Apt 2E Brooklyn, NY 11226; E-mail:

The authors report no conflicts of interest.

© 2017 by North American Neuro-Ophthalmology Society