Parinaud syndrome, also known as dorsal midbrain syndrome, is a supranuclear vertical gaze disturbance caused by pathology of the dorsal midbrain region, often, but not exclusively, via compression of the superior tectal plate.
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Clinical presentation
Parinaud syndrome is characterised by a classic triad of findings 4:
upward gaze palsy, often manifesting as diplopia
pupillary light-near dissociation (pupils respond to near stimuli, but not light)
convergence-retraction nystagmus
Other clinical features which may be present 4:
bilateral upper eyelid retraction (Collier sign)
downbeat nystagmus
Pathology
Its importance lies in that recognition of Parinaud syndrome localises pathology to impingement of or origin in the tectal plate, most frequently due to a posterior commissure or pineal region mass (typically solid tumours rather than pineal cysts). However, Parinaud syndrome can also frequently be caused by haemorrhagic stroke, ischaemic stroke, demyelination, and other aetiologies 4.
History and etymology
Named after Henry Parinaud (1844-1905), a French ophthalmologist.
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