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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.
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 ...
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.
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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]