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[Parinaud's syndrome in children]
F Aguilar-Rebolledo1, A Zárate-Moysén, G Quintana-Roldán
1Servicio de Neurología, Centro Médico Nacional Siglo XXI, IMSS, México, D.F.
Insights
Parinaud's syndrome in children is often caused by tumors, unlike in adults. These masses disrupt midbrain connections, leading to specific neurological symptoms.
Area of Science:
- Pediatric Neurology
- Ophthalmology
- Neuro-oncology
Context:
- Parinaud's syndrome, characterized by vertical gaze palsy, is a rare neurological condition.
- Etiology and clinical presentation in pediatric cases require distinct understanding compared to adults.
Purpose:
- To detail the clinical manifestations and etiological factors of Parinaud's syndrome in a pediatric cohort.
- To investigate the underlying causes and treatment outcomes for children diagnosed with this syndrome.
Summary:
- Eleven children with Parinaud's syndrome were analyzed, with a mean age of 10 years.
- Tumors (primarily pineal germinoma) were the leading cause (7/11 cases), followed by arachnoid cysts, cysticercosis, tuberculoma, and multiple sclerosis.
- Treatment involved surgical interventions (ventriculoperitoneal shunt), chemotherapy, radiotherapy, and steroids, depending on the etiology.
Impact:
- Findings highlight the significant association of mass lesions, particularly tumors, with Parinaud's syndrome in children.
- This contrasts with adult presentations and emphasizes the need for neuroimaging to identify structural causes.
- Understanding these pediatric-specific etiologies guides appropriate diagnostic and therapeutic strategies.
Objective:
To describe the clinical and ethiologic findings of children with Parinaud's syndrome.
Material And Methods:
11 children fulfilling the clinical criteria for Parinaud's syndrome were studied. The mean age was 10 years with a range of 10 months to 14 years.
Results:
Seven cases were tumors (pineal germinoma in four and one each with teratoma, astrocytoma, and an undefined tumor); the remaining 4 cases corresponded to arachnoid cyst in the III ventricule, cysticercosis, tuberculoma and multiple sclerosis. The main treatment was surgical including ventriculoperitoneal shunt because of hydrocephalous secondary to mechanical obstruction. Chemotherapy and radiotherapy were also used for the tumor cases, and steroids for the multiple sclerosis patient.
Conclusions:
In contrast to adults, Parinaud's syndrome in our children was associated with a mass, mainly tumoral, which interrupted the afferent and efferent connections of the midbrain structures, such as posterior commissure, riMLF or the interstitial nucleus of Cajal.