Dorsal midbrain syndrome

Definition

Parinaud syndrome is an eye problem similar to conjunctivitis ("pink eye"). It usually affects only one eye and is accompanied by nearby swollen lymph nodes and an illness with a fever.

Alternative Names

Causes

Many different infections can cause Parinaud syndrome, including bacteria, viruses, fungi and parasites.

The most common causes are tularemia (rabbit fever) and cat-scratch fever. Tularemia can infect the eye either by direct entry of the bacteria into the eye (on a finger or other object), or by air droplets that carry the bacteria, and then land on the eye. Other infectious diseases may spread by these mechanisms, or through the bloodstream to the eye.

Symptoms

The eye is often red, irritated, and painful, similar to conjunctivitis

Exams and Tests

An examination shows a red, tender, inflamed eye with possible ulcers in the cornea (surface). Tender lymph nodes may be present in front of the ear. These lymph nodes can fester, depending on the cause of the infection. A fever and other signs of generalized illness may also be found.

The white blood cell count may be high or low, depending on the cause of the infection. For many of the infections that cause Parinaud syndrome, blood tests to check antibody levels are the main methods used to make a diagnosis. Sometimes, culture of the eye, lymph node, or blood, or biopsy of the lymph node, can be helpful.

Treatment

Depending on the cause of the infection, antibiotics may be helpful. Surgery may be necessary to clean away the infected tissues.

Outlook (Prognosis)

The outlook depends on the cause of the infection. In general, if the diagnosis is made early and treatment starts immediately, the outcome of Parinaud syndrome can be very good.

Possible Complications

• It is possible for the infection to spread into nearby tissues or into the bloodstream.
• Eye complications resulting in blindness can occur.

When to Contact a Medical Professional

You should call your health care provider if you develop a red, irritated, painful eye.

Prevention

Frequent hand washing can reduce the likelihood of acquiring Parinaud syndrome. Specifically, tularemia can be avoided by not having contact with wild rabbits, squirrels, or ticks.