Parinaud's syndrome

pretectal syndrome
Parinaud's syndrome, also known as dorsal midbrain syndrome, vertical gaze palsy, and sunset sign, is an inability to move the eyes up and down.wikipedia
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Henri Parinaud

Henri Parinaud (1844-1905)
It is caused by lesions of the upper brain stem and is named for Henri Parinaud (1844–1905), considered to be the father of French ophthalmology.
He is well known for the medical term Parinaud's syndrome, which is, "A dorsal midbrain lesion such as pinealoma which results in vertical gaze palsy, convergence-retraction nystagmus and light-near dissociation".

Collier's sign

Eyelid retraction (Collier's sign)
Causes include 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.

Hydrocephalus

hydrocephalyhydrocephaliccongenital hydrocephalus
However, any other compression, ischemia or damage to this region can produce these phenomena: obstructive hydrocephalus, midbrain hemorrhage, cerebral arteriovenous malformation, trauma and brainstem toxoplasmosis infection.
Focal neurological deficits may also occur, such as abducens nerve palsy and vertical gaze palsy (Parinaud syndrome due to compression of the quadrigeminal plate, where the neural centers coordinating the conjugated vertical eye movement are located).

Argyll Robertson pupil

Dr Argyll Robertson
Pseudo-Argyll Robertson pupils: Accommodative paresis ensues, and pupils become mid-dilated and show light-near dissociation.
A third cause of light-near dissociation is Parinaud syndrome, also called dorsal midbrain syndrome.

Pinealoma

Pineal astrocytoma
Young patients with brain tumors in the pineal gland or midbrain: pinealoma (intracranial germinomas) are the most common lesion producing this syndrome.
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 or Dorsal Mid-brain syndrome, are the only physical symptoms seen.

Pineal gland

pinealpineal foramenpineal body
Young patients with brain tumors in the pineal gland or midbrain: pinealoma (intracranial germinomas) are the most common lesion producing this syndrome.
A pineal tumor can compress the superior colliculi and pretectal area of the dorsal midbrain, producing Parinaud's syndrome.

Rostral interstitial nucleus of medial longitudinal fasciculus

rostral interstitial nucleusvertical gaze center
It is caused by compression of the vertical gaze center at the rostral interstitial nucleus of medial longitudinal fasciculus (riMLF).

Eye movement

eye movementsversionmovements of the eye
It is a group of abnormalities of eye movement and pupil dysfunction.

Pupil

pupilspupillaryanatomical pupil
It is a group of abnormalities of eye movement and pupil dysfunction.

Lesion

lesionsbrain lesionslesion studies
It is caused by lesions of the upper brain stem and is named for Henri Parinaud (1844–1905), considered to be the father of French ophthalmology.

Brainstem

brain stembrain-stemback of the skull
It is caused by lesions of the upper brain stem and is named for Henri Parinaud (1844–1905), considered to be the father of French ophthalmology.

Ophthalmology

ophthalmologistophthalmicoculist
It is caused by lesions of the upper brain stem and is named for Henri Parinaud (1844–1905), considered to be the father of French ophthalmology.

Papilledema

papilloedemaP'''apilledemaSwelling of the optic disc (papilledema)
It is also commonly associated with bilateral papilledema.

Accommodation reflex

accommodationaccommodatingaccommodative
It has less commonly been associated with spasm of accommodation on attempted upward gaze, pseudoabducens palsy (also known as thalamic esotropia) or slower movements of the abducting eye than the adducting eye during horizontal saccades, see-saw nystagmus and associated ocular motility deficits including skew deviation, oculomotor nerve palsy, trochlear nerve palsy and internuclear ophthalmoplegia.

Esotropia

cross-eyedaccommodative esotropiacross-eye
It has less commonly been associated with spasm of accommodation on attempted upward gaze, pseudoabducens palsy (also known as thalamic esotropia) or slower movements of the abducting eye than the adducting eye during horizontal saccades, see-saw nystagmus and associated ocular motility deficits including skew deviation, oculomotor nerve palsy, trochlear nerve palsy and internuclear ophthalmoplegia.

Nystagmus

nystagmus, pathologicinvoluntary eye movementsnystagmus, congenital
It has less commonly been associated with spasm of accommodation on attempted upward gaze, pseudoabducens palsy (also known as thalamic esotropia) or slower movements of the abducting eye than the adducting eye during horizontal saccades, see-saw nystagmus and associated ocular motility deficits including skew deviation, oculomotor nerve palsy, trochlear nerve palsy and internuclear ophthalmoplegia. Convergence-retraction nystagmus: Attempts at upward gaze often produce this phenomenon. On fast up-gaze, the eyes pull in and the globes retract. The easiest way to bring out this reaction is to ask the patient to follow down-going stripes on an optokinetic drum.

Skew deviation

It has less commonly been associated with spasm of accommodation on attempted upward gaze, pseudoabducens palsy (also known as thalamic esotropia) or slower movements of the abducting eye than the adducting eye during horizontal saccades, see-saw nystagmus and associated ocular motility deficits including skew deviation, oculomotor nerve palsy, trochlear nerve palsy and internuclear ophthalmoplegia.

Trochlear nerve

trochlearIVfourth
It has less commonly been associated with spasm of accommodation on attempted upward gaze, pseudoabducens palsy (also known as thalamic esotropia) or slower movements of the abducting eye than the adducting eye during horizontal saccades, see-saw nystagmus and associated ocular motility deficits including skew deviation, oculomotor nerve palsy, trochlear nerve palsy and internuclear ophthalmoplegia.

Internuclear ophthalmoplegia

It has less commonly been associated with spasm of accommodation on attempted upward gaze, pseudoabducens palsy (also known as thalamic esotropia) or slower movements of the abducting eye than the adducting eye during horizontal saccades, see-saw nystagmus and associated ocular motility deficits including skew deviation, oculomotor nerve palsy, trochlear nerve palsy and internuclear ophthalmoplegia.

Progressive supranuclear palsy

supranuclear palsysupranuclear palsy, progressiveParkinson's disease with hyperextension
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.

Vestibulo–ocular reflex

vestibulo-ocular reflexoculocephalic reflexoculovestibular reflex
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.

Eyelid

eyelidspalpebralpalpebra
Eyelid retraction (Collier's sign)

Cerebral shunt

shuntventriculoperitoneal shuntcerebrospinal fluid shunts
Conjugate down gaze in the primary position: "setting-sun sign". Neurosurgeons see this sign most commonly in patients with failed hydrocephalus shunts.

Midbrain

mesencephalonmid-brainmesencephalic
Young patients with brain tumors in the pineal gland or midbrain: pinealoma (intracranial germinomas) are the most common lesion producing this syndrome. Parinaud's syndrome results from injury, either direct or compressive, to the dorsal midbrain. Specifically, compression or ischemic damage of the mesencephalic tectum, including the superior colliculus adjacent oculomotor (origin of cranial nerve III) and Edinger-Westphal nuclei, causing dysfunction to the motor function of the eye.

Superior colliculus

optic tectumsuperior colliculicolliculi
Specifically, compression or ischemic damage of the mesencephalic tectum, including the superior colliculus adjacent oculomotor (origin of cranial nerve III) and Edinger-Westphal nuclei, causing dysfunction to the motor function of the eye.