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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.
The symptoms and signs associated with convergence insufficiency are related to prolonged, visually demanding, near-centered tasks. They may include, but are not limited to, diplopia (double vision), asthenopia (eye strain), transient blurred vision, difficulty sustaining near-visual function, abnormal fatigue, headache, and abnormal postural adaptation, among others.
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.
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]
The most common cause of POS is cat-scratch disease, an infectious disease that typically results from a scratch or bite from a cat. However, this syndrome is an unusual feature of cat-scratch disease. In rare cases, other infections may also cause the syndrome. [1] Bartonella henselae [2] Francisella tularensis [3] Herpes simplex virus type 1 [4]
This can result in vision changes and Parinaud's syndrome. [3] Due to the aggressive nature of the disease, tumor spread at the time of diagnosis is common. [13] Pineoblastomas often invades locally, with spread to the head and spine seen in 25–41% of patients. [3] While CNS spread is relatively common, these tumors rarely cause distant ...
Causes: 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