Parinaud syndrome is an eye condition similar to conjunctivitis in that the ocular tissue becomes red and painful. Pupil dysfunction and abnormal eye movement may also result. Additional symptoms include swollen lymph nodes near the affected eye as well as fever. Parasites, lesions on the upper brain stem, and viruses and bacteria are all known to cause this syndrome. Common treatment options include antibiotics and surgery, depending on the cause.
Rabbit and cat-scratch fever are the two most common causes of Parinaud syndrome. The eye becomes infected by bacteria via direct contact of an object or finger. The bacteria can also enter the eye through the air or the bloodstream. Brain injury to the dorsal midbrain is another possible cause.
The symptoms of classic Parinaud syndrome are like those of conjunctivitis or pink eye. An eye is red, painful, and irritated with increased tearing. The sufferer will also experience a general feeling of being sick and have fever and swollen lymph nodes. The affected lymph nodes are typically located in front of the ear.
Abnormal eye movements are also observed in patients with this syndrome. The up gaze may become paralyzed, the pupils can become dysfunctional, and the eyelid can retract. Such eye movement problems are seen when the cause is a brain injury, multiple sclerosis, or stroke. Most patients will improve slowly over a period of months.
A diagnosis of Parinaud syndrome begins with an examination of the affected eye for signs of redness and irritation as well as the presence of tender lymph nodes near the ear. There may also be ulcers on the cornea. A doctor can order a blood test to check for signs of infection. A white blood cell count that is too low or too high is often evidence of an infection.
Additional diagnostic tests include blood tests for certain antibody levels. Laboratory cultures of eye secretions, blood, or lymph node tissue can also be helpful. A biopsy may also be performed on the affected lymph nodes. The diagnostic test will depend on the suspected cause of Parinaud syndrome.
The treatment of this syndrome depends on the illness that caused it. If a diagnosis is made early, treatment can begin immediately. Early treatment often indicates a positive prognosis for recovery. Antibiotics are used to combat infection, but infected ocular tissues may need to be removed via surgical procedure.
Blindness is a possible complication of Parinaud syndrome. If the cause of the syndrome is an infection, the infection can spread to other tissues via the bloodstream. A health care professional should be consulted at the first sign of symptoms to avoid serious complications.
The most effective ways to prevent Parinaud syndrome are to maintain good hand washing habits and prevent brain injury. Avoiding touching or rubbing the eyes is also helpful. Rabbit and cat-scratch fever, the most common causes of Parinaud syndrome, can be avoided by not touching ticks, squirrels, or wild rabbits.