"Parinaud syndrome" - a case report / Julia Mercedes C. Villalva and Miriam Louella D. Fermin.

Includes bibliographical references.

Abstract: This is a case of an 11-year old male who presented with progressive headache accompanied by limited upgaze n both eyes. Patient complained of generalized headache, throat pain and low-grade fever, and was diagnosed with Acute Tonsillopharyngitis by his Pediatrician. Analgesics and antibiotics were given which provided temporary relief. Due to persistent headache and an episode of projectile vomiting, patient sought consult to an Ophthalmologist and he was given prescription glasses for Astigmatism, which did not afford relief. Patient was admitted to another institution due to worsening of symptoms. Patients was subsequently discharged as improved with a diagnosis of Urinary Tract Infection. A few days later, another episode of projectile vomiting associated with headache, diplopia and seizure occurred which prompted admission. Significant ophthalmologic findings include non-reactive pupils to direct light and limitation of eye movement on upgaze with nystagmus. MRI with contrast was done and revealed a heterogeneously mass at the pineal region, measuring 37x26x35 mm. An emergency ventriculoperitoneal shunt was done due to another seizure episode. Patient underwent adjuvant radiotherapy, chemotherapy and total mass excision, which revealed a histologic finding of Teratoma. Despite optimal therapy, patient passed away as result of multi-organ failure.

Research - Department of Ophthalmology