Parinaud syndrome

Last revised by Dr Calum Worsley on 19 Dec 2021

Parinaud syndrome, also known as the dorsal midbrain syndrome, is a supranuclear vertical gaze disturbance caused by compression of the superior tectal plate.

Parinaud syndrome is characterized by a classic triad of findings:

  • upward gaze palsy, often manifesting as diplopia
  • pupillary light-near dissociation (pupils respond to near stimuli, but not light)
  • convergence-retraction nystagmus

Its importance lies in that recognition of Parinaud syndrome localizes pathology to impingement of or origin in the tectal plate, most frequently due to a posterior commissure or pineal region mass (typically solid tumors rather than pineal cysts).

Named after Henry Parinaud, a French ophthalmologist (1844-1905).

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Cases and figures

  • Case 1: from pineal germinoma
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