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TitleDescriptionSubject
1 Bilateral riMLF Syndrome Causing Vertical Saccadic Palsy and Loss of Ipsitorsional Fast PhasesThis is a 60-year-old man who developed fatigue and diabetes insipidus about 12 months prior to this video, and MRI demonstrated hypothalamic enhancement at that time. Nine months prior to this video, he gradually noticed that he was unable to look down. Work-up for ischemic, infectious, inflammator...Midbrain OMS; Downgaze Palsy; Upgaze Palsy; Vertical Gaze Palsy; Abnormal Saccades; Normal Pursuit
2 Dorsal Midbrain Syndrome from Stroke - Collier's Sign & PseudoabducensThis is a 70-yo-man who suffered a right midline thalamic/rostral midbrain hemorrhagic stroke causing a pretectal (Parinaud's) syndrome. There was prominent eyelid retraction (Collier's sign), a left pseudo-abducens, and upgaze palsy with convergence retraction nystagmus. There was no light-near dis...OMS Mesenecephalon; Convergence Reaction Nystagmus; Upgaze Palsy; Abnormal Range; Sixth Nerve Palsy; Vertical Gaze Palsy; Eyelid Retraction; OMS Dorsal Midbrain
3 Isolated Central 4th Nerve Palsy𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 40-year-old man with a right hypertropia that worsened in left and down gaze in addition to right head tilt, and improved in left head tilt. There was subjective excyclotorsion OD with double Maddox rod testing....Fourth Nerve Palsy; OMS Midbrain
4 Parinaud's Syndrome in a Man with GBM of the Pineal Gland𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 60-yo-man who presented with diplopia, headaches, and difficulty looking up, and was found to have a mass involving the pineal gland. Biopsy was diagnostic of a GBM. Major features of Parinaud's (dorsal midbrain...Saccades; Convergence; Range; Dorsal Midbrain Syndrome; Convergence Retraction Nystagmus; Upgaze Palsy
5 Parinaud's Syndrome with Impaired Upward Saccades and Otherwise Normal Vertical Eye MovementsThis is a 50-yo-man who suffered a dorsal midbrain stroke. Exam demonstrated normal vertical range of eye movements, normal vertical VOR and smooth pursuit, but inability to perform upward saccades. Another feature of Parinaud's syndrome seen on his exam was light-near dissociation (not shown in thi...Abnormal Saccades; Range of Eye Movements; Abnormal Range of Eye Movements; Smooth Pursuit; Normal VOR; Dorsal Midbrain Syndrome
6 Paroxysmal Ocular Tilt Reaction𝗢𝗿𝗶𝗴𝗶𝗻𝗮𝗹 𝗗𝗲𝘀𝗰𝗿𝗶𝗽𝘁𝗶𝗼𝗻: This is a 60-year-old woman who 2 years prior experienced a left sided hypertensive hemorrhagic stroke, resulting in right hemiparesis, dysarthria and vertical diplopia. The initial vertical diplopia resolved completely a...Midbrain OMS; Skew Deviation; Jerk Nystagmus; Abnormal Alignment
7 Test Your Knowledge - Parinaud's Syndrome in NeurosarcoidosisWatch the first segment of the video up to "Stop! What would you expect with vertical gaze?" and select the best response below. The patient also has mild right-beating nystagmus which can be ignored for the purposes of this question. A. The patient has pupillary findings consistent with bilateral 3...Normal Convergence; Vertical Gaze Palsy; Upgaze Palsy; Dorsal Midbrain; Mesencephalon; Convergence Retraction
8 Two Patients with Parinaud's Syndrome with Slow Upward Saccades and Normal Upward Range of MovementsPresented here are two patients with Parinaud's syndrome: Patient 1) suffered a hemorrhage of the dorsal midbrain causing slow upward saccades (with convergence retraction nystagmus, but normal vertical range of eye movements), and light-near dissociation, and Patient 2) had a germinoma of the dorsa...Abnormal Saccades; Dorsal Midbrain; Jerk Nystagmus; Gaze Evoked Nystagmus
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