title: Parinaud «plus» syndrome in a patient with dysgerminoma.
abstract: METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Servicio de Oftalmología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España. Electronic address: casamata@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: Burgueño-Montañés
authors.affiliation: Servicio de Oftalmología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
authors.forename: C
authors.initials: C
authors.lastname: Santalla-Castro
authors.affiliation: Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
authors.forename: J
authors.initials: J
authors.lastname: Peña-Suárez
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D004172:Diplopia / Q000000981:diagnostic imaging / Q000209:etiology*; D005047:Etoposide / Q000008:administration & dosage; D018237:Germinoma / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D006801:Humans; D008297:Male; D015835:Ocular Motility Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D059545:Paraneoplastic Syndromes, Ocular / Q000000981:diagnostic imaging / Q000209:etiology*; D010871:Pinealoma / Q000150:complications* / Q000188:drug therapy / Q000532:radiotherapy; D012074:Remission Induction; D014549:Urinary Incontinence / Q000209:etiology; D017287:Ventriculoperitoneal Shunt
chemical_list: D005047:Etoposide; D002945:Cisplatin
keywords: Disgerminoma; Dorsal midbrain syndrome; Dysgerminoma; Germinoma; Parinaud's syndrome; Pineal tumours; Síndrome de Parinaud; Síndrome mesencefálico dorsal; Tumores pineales