E-Pearl of the Week: Dorsal Midbrain Syndrome

October 23, 2012

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October 23, 2012

Dorsal Midbrain Syndrome

The dorsal midbrain syndrome is comprised of supranuclear vertical gaze palsy, eyelid retraction, convergence–retraction nystagmus, and light–near dissociation of the pupillary reflex. It is also called Parinaud syndrome, named for a French ophthalmologist who practiced in the late 1800s. The clinical signs are caused by injury to the dorsal midbrain. The finding of preserved vestibulo–ocular, or oculocephalic, reflexes helps the clinician differentiate this central gaze palsy from a peripheral one. This is most commonly a result of pineal gland region tumors and hydrocephalus. Stroke and demyelinating disease are other potential causes of the dorsal midbrain syndrome.

Reference

1. Pearce JMS. Parinaud's syndrome. J Neurol Neurosurg Psychiatry 2005; 76: 99.
2. Lindbauer N, Strenger V, Urban C. Teaching Neuroimages: Dorsal Midbrain (Parinaud) Syndrome with Corectopia. Neurology 2012; 79: e154.

Submitted by: Jennifer E. Fugate, DO

Disclosure: Dr. Fugate serves on the editorial team for the Neurology Resident and Fellow Section.

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