Farlex Partner Medical Dictionary © Farlex 2012
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Pineal tumours are one of the most common causes of Parinaud's syndrome, also known as the 'setting sun' phenomenon.
The clinical presentation is mainly related to the tumor location [5]: suprasellar lesions cause diabetes insipidus (DI), hypopituitarism, or bilateral temporal hemianopsia, whereas lesions of the pineal region produce signs of increased intracranial pressure (ICP) due to obstructive hydrocephalus, Parinaud's syndrome, ataxia, behavioral changes, and seizure.
Secondly, ischemic lesion extended to the rostral interstitial nucleus of the medial longitudinal fascicles (riMLF) or interstitial nucleus of Cajal placed in rostral-medial side of the red nucleus might bring Parinaud's syndrome [12].
Complications such as Parinaud's oculoglandular syndrome, erythema nodosum, and granulomas in the liver and spleen occur in approximately 10% of immunocompetent children [2].
[49] Parinaud et al observed that when both [IgG.sub.1] and [IgG.sub.3] were present, [IgG.sub.1] was usually preponderant and most severe disease was correlated with [IgG.sub.1] levels.
(4,5) The clinical manifestations of ocular involvement include Parinaud oculoglandular syndrome, neuroretinitis, choroidal mass, retinal infiltrate, choroiditis, branch retinal vessel occlusion, serous retinal detachment, intermediate uveitis, acute endophthalmitis, and anterior uveitis.
When ocular involvement is present, the disease is termed "ocular bartonellosis." The spectrum of ocular bartonellosis manifestation is wide, ranging from neuroretinitis to Parinaud's oculoglandular syndrome, which is an unusual syndrome characterized by granulomas in the eye, preauricular lymphadenopathy, and positive skin test to Bartonella spp.
henselae infection experience more serious manifestations, such as neuroretinitis, Parinaud oculoglandular syndrome, osteomyelitis, encephalitis, or endocarditis (1).
Other causes which lead to bilateral mydriasis include toxic conditions (atropine intoxication, Parkinson drugs, antidepressants, carbonmonoxide intoxication, cocaine), conditions secondary to morbidities (migraine, schizophrenia, hyperthyroidism, coma) and Parinaud oculoglandular syndrome.
Particularly concerning to clinicians was the patient's comatose appearance--a fixed downward gaze consistent with a Parinaud's Syndrome; such a gaze is a warning of potential irreversible brain damage.