Parinaud syndrome causes red and painful eyes, abnormal eye movements, swollen lymph nodes, and fever. It can be caused by parasites, brain injury, or bacteria/viruses. Treatment depends on the cause and may include antibiotics or surgery. Prevention includes good hand hygiene and avoiding touching the eyes.
Parinaud syndrome is an eye condition similar to conjunctivitis in that eye tissue becomes red and painful. Pupil dysfunction and abnormal eye movements may also result. Additional symptoms include swollen lymph nodes near the affected eye and fever. Parasites, lesions on the upper brainstem, 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’s syndrome. The eye becomes infected with bacteria through direct contact with an object or finger. Bacteria can also enter the eye through the air or 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. One eye is red, painful and irritated with increased tearing. The sufferer will also experience a general feeling of being unwell and have a fever and swollen lymph nodes. The affected lymph nodes are usually located in front of the ear.
Abnormal eye movements are also seen in patients with this syndrome. Upgazing can become paralyzed, the pupils can become dysfunctional, and the eyelid can retract. Such eye movement problems occur when the cause is a brain injury, multiple sclerosis, or stroke. Most patients will slowly improve 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 may order a blood test to check for signs of infection. Too low or too high a white blood cell count is often evidence of an infection.
Additional diagnostic tests include blood tests for certain levels of antibodies. Laboratory cultures of eye secretions, blood, or lymph node tissue may also be helpful. A biopsy may also be performed on the affected lymph nodes. Diagnostic testing will depend on the suspected cause of Parinaud’s syndrome.
Treatment of this syndrome depends on the disease that caused it. If an early diagnosis is made, treatment can begin immediately. Early treatment often indicates a positive prognosis for recovery. Antibiotics are used to fight infection, but infected eye tissue may need to be removed surgically.
Blindness is a possible complication of Parinaud’s syndrome. If the cause of the syndrome is an infection, the infection can spread to other tissues through the bloodstream. A healthcare professional should be consulted at the first sign of symptoms to avoid serious complications.
The most effective ways to prevent Parinaud’s syndrome are to maintain good hand washing habits and prevent brain injury. It’s also helpful to avoid touching or rubbing your eyes. Rabbit and cat-scratch fever, the most common causes of Parinaud’s syndrome, can be avoided by not touching ticks, squirrels or wild rabbits.
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