RESUMO
OBJECTIVE: We undertook this study to describe the causes of Parinaud syndrome (PS) with diplopia to determine a topographic diagnosis and prognosis. METHODS: We studied patients with PS from January 1980 to January 2004 and reviewed causes and treatment. We identified all strabismus associated with PS. RESULTS: We included 18 patients with diplopia, 6 females and 12 males. Median age was 28 years old, SD 22 (10; CI 95%). Results are strabismus related: III nerve palsy in 15 patients (79%), optical nerve damage in 8 (44.4%), VII nerve palsy in 3, IV nerve palsy 2, bilateral III nerve palsy 2, nystagmus 2, Foville syndrome 2, one-and-a-half syndrome (1). The following causes were reported: tumors (6), brain stroke (4), cranial trauma (3), neurocysticercosis (2). Orthoposition under botulinum toxin treatment was obtained in 1.72 +/- 1.1 (0.65 CI 95%). Surgery was done in nine patients, and only one patient had spontaneous resolution of diplopia and PS. CONCLUSIONS: It is important to identify the topographic diagnosis and prognosis of brain diseases such as the complete study of strabismus-related PS. In this way we can learn more about the extent of damage and can identify recurrences quickly in order to offer better control.
Assuntos
Transtornos da Motilidade Ocular/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Diplopia/complicações , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Transtornos da Motilidade Ocular/diagnóstico , Estudos Retrospectivos , Estrabismo/complicaçõesRESUMO
Objetivo: Describir los estrabismo asociados al Síndrome de Parinaud (SP). Métodos: Se estudiaron pacientes con SP de 1998 a 2004 asociados a otros estrabismos. Resultados: Total 18 pacientes, 6 mujeres y 12 hombres. Edad: 28 años DE 22 (10; 1C 95 por ciento). Lesión al III nervio craneal en 15 pacientes (79 por ciento), II nervio: 8 pacientes (44.4 por ciento), VII nervio: 3 pacientes, hemiparesia: 3, lesión a IV nervio 2, parálisis bilateral de III nervio 2, nistagmus 2, Síndrome de foville 2, y síndrome de uno y medio 1 paciente. Causas: Accidente vascular cerebral 4, uno de ellos asociado a infarto agudo de miocardio, traumatismo cráneo-encefálico 3, tumor cerebral 6, neurocisticercosis 2. Se obtuvo ortoposición con toxina botulínica en 1.72 +/- 1.1 (0.65 IC 95) y cirugía en 9, mejoría espontánea 1. Conclusiones: Identificar el diagnóstico topográfico y pronóstico de la lesión cerebral asociada a SP es muy importante en el control y vigilancia del paciente así como para ofrecer una rehabilitación mas dirigida.
Objective: To describe the causes of Parinaud syndrome (PS) with diplopia to determine a topographic diagnosis and prognosis. Method: We studied patients with SP from January 1980 to January 2004; causes and treatment. We identified all strabismus associated to PS. Results: We included 18 patients with diplopia, 6 female and 12 male. Age: 28 years old, SD 22 (10; CI 95 percent). Related strabismus: III nerve palsy in 15 patients (79 percent), optical nerve damage in 8 (44.4 percent), VII nerve palsy in 3, IV nerve palsy 2, bilateral III nerve palsy 2, nystagmus 2, Foville syndrome 2, One and half syndrome 1. Causes: Tumor 6, brain stroke 4, cranial trauma 3, neurocisticercosis 2. Ortoposition with botulinum toxin treatment was obtained with 1.72 +/-1.1 (0.65; IC 95 percent) inyections. Surgery was done in 9 patients, only one patient had spontaneous resolution of diplopia and SP. Conclusions: To identify the topographic diagnosis and prognosis of brain diseases in PS is very important to complete the study of strabismus. In this way we can know more about of damage extension and we can identify recurrences quickly to offer a better control.