Parinaud «plus» syndrome in a patient with dysgerminoma

Abstract

Clinical case: A 33-year-old male diagnosed with Parinaud's syndrome, exotropia and post-papillary oedema optic atrophy in his left eye. A pineal germinoma was diagnosed after performing neuroimaging scans and a stereotactic biopsy. He was treated with chemotherapy and radiotherapy, showing a complete pathological response. The Parinaud's syndrome persists one year after diagnosis and the patient has refused to have strabismus surgery.

Discussion: Parinaud's syndrome consists of a supranuclear vertical gaze palsy resulting from damage to the midbrain tectum. The involvement of adjacent structures leads to the «Parinaud-plus» syndrome. When a Parinaud's syndrome is accompanied by diplopia («Parinaud-plus» syndrome), extension of the injury into adjacent areas must be considered.

Keywords: Disgerminoma; Dorsal midbrain syndrome; Dysgerminoma; Germinoma; Parinaud's syndrome; Pineal tumours; Síndrome de Parinaud; Síndrome mesencefálico dorsal; Tumores pineales.