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Parinaud's syndrome is a cluster of abnormalities of eye movement and pupil dysfunction, characterized by: Paralysis of upwards gaze: Downward gaze is usually preserved. This vertical palsy is supranuclear , so doll's head maneuver should elevate the eyes, but eventually all upward gaze mechanisms fail.
A third cause of light-near dissociation is Parinaud syndrome, also called dorsal midbrain syndrome. This uncommon syndrome involves vertical gaze palsy associated with pupils that “accommodate but do not react." [5] The causes of Parinaud syndrome include brain tumors (pinealomas), multiple sclerosis and brainstem infarction.
Frequently, paralysis of upward gaze along with several ocular findings such as convergence retraction nystagmus and eyelid retraction also known as Collier's sign and Light Near Dissociation (pupil accommodates but doesn't react to light) are known collectively as Parinaud's syndrome [1] or Dorsal Mid-brain syndrome, are the only physical ...
Cyclotropia can be detected using subjective tests such as the Maddox rod test, the Bagolini striated lens test, [6] the phase difference haploscope of Aulhorn, [6] or the Lancaster red-green test (LRGT). Among these, the LRGT is the most complete. [7] Cyclotropia can also be diagnosed using a combination of subjective and objective tests.
Parinaud's syndrome, which can mimic some aspects of spasm of the near reflex, such as excessive accommodation and convergence; however, pupillary near-light dissociation, not miosis, is a feature of Parinaud's syndrome. [8]
Oculomotor nerve palsy or oculomotor neuropathy [1] is an eye condition resulting from damage to the third cranial nerve or a branch thereof. As the name suggests, the oculomotor nerve supplies the majority of the muscles controlling eye movements (four of the six extraocular muscles, excluding only the lateral rectus and superior oblique).
Upper dorsal midbrain supranuclear lesions such as Parinaud's syndrome, 'top of the basilar syndrome', midbrain infarction, neurodegeneration or tumour, multiple sclerosis, encephalitis, and Miller-Fisher syndrome. Damage to the posterior commissure levator inhibitory fibres which originate in the M-group of neurons. Differential diagnosis
With heterotropia, a correcting movement of the eye can be detected already by the simple cover test; with heterophoria, such correcting movement only takes place in the cross-cover test. People with heterophoria are able to create and maintain binocular fusion through vergence , and the cross-cover test purposely breaks this fusion, making the ...