Parinaud’s Syndrome

Parinaud’s Syndrome

Parinaud’s syndrome, or the dorsal midbrain syndrome, or the pretectal syndrome, consists of:

Paralysis of vertical gaze, especially upgaze, with or without mydriasis
Loss of pupillary light reflexes (light-near dissociation) Loss of convergence
Convergence or retraction nystagmus
Upper eyelid retraction (Collier’s "tucked lid" sign).

Bell’s phenomenon is usually lost.
This constellation of signs results from dorsal midbrain lesions, such as pineal tumors, which affect the pretectum and posterior commissure and so interfere with conjugate eye movements in the vertical plane.

References
Keane JR. The pretectal syndrome: 206 patients. Neurology 1990; 40: 684-690
Parinaud H. Paralysie des mouvements associés des yeux. Archives deNeurologie Paris 1883; 5: 145-172
Pearce JMS. Parinaud’s syndrome. Journal of Neurology, Neurosurgeryand Psychiatry 2005; 76: 99
Pierrot-Deseilligny C, Chain F, Gray M et al. Parinaud’s syndrome.
Brain 1982; 105: 667-696

Cross References

Collier’s sign; Light-near pupillary dissociation; Nystagmus; Supranuclear gaze palsy