Parinaud syndrome (also known as the dorsal midbrain syndrome) is a supranuclear vertical gaze disturbance caused by compression of the tectal plate. This is most frequently due to a posterior commisure or pineal region mass (typically solid tumours rather than pineal cysts).
It is characterised by:
- a deficiency in upward-gaze
- pupillary light-near dissociation (pupils respond to near stimuli but not light)
- convergence-retraction nystagmus
Treatment is primarily directed towards the etiology of dorsal midbrain syndrome. A thorough work up including neuroimaging is essential to rule out the various causes of dorsal midbrain syndrome.