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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.
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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