Parinaud syndrome is also called dorsal midbrain syndrome. It is due to compression of some delicate structures at the base of the brain. Your combination of arachnoid cyst and hydrocephalus is a classic cause. IF you have been shunted, then it is possible that you are over-draining. I have seen this situation 2 or 3 times. If you have a shunt, talk to your neurosurgeon about possibly increasing your ICP a little bit to see what happens. You need to have an adjustable shunt to do this.
Thanks for your reply!
I do have a VP shunt but it's non-adjustable. I had the Parinaud's before my 1994 neurosurgery. I had a second strabismus surgery in late 1993--I have always had exotropia most likely caused by the AC and Hydro. Post-surgery, my opthamologist did not like the way I was recovering because I could not move my left eye upward when doing tracking tests, so she had me go through many medical tests until finally getting a scan of my brain. The scan(s) revealed the large AC and hydro which affected many vision related areas of my brain--including the part that specifically causes Parinaud's. I also had many other Hydro and AC symptoms throughout my life. I had a VP shunt inserted in 1994.
I would like to know what is the significance of not being able to gaze upward? Is it important to have this function? I'm 43, is it worth pursuing surgery to fix the lack of upward gaze? As far as I know, I can see objects when tested for tracking--I just can't move my eye(s) in the upward direction.
Parinaud syndrome is a "supra-nuclear" eye movement disorder, which means that your brain will never tell your eyes to move upwards even when "you" (the person) want to look upward. I would never advise eye muscle surgery in Parinaud syndrome unless the patient also had double vision, which can occur when the P.S. affects the eyes unequally. In the modern world, upgaze is the least important field of gaze unless you're an electrician or an artist who paints ceilings. If you can read, drive, and perform most of your activities of daily living without double vision, why risk tinkering with upgaze surgically?
Thank you very much for your replies. You have been very helpful and your replies were very informative. When I found out about my Arachnoid Cyst and hydrocephalus fifteen years ago, I did not focus on the presence of Parinaud's Syndrome and its effect on my eyes. I recently acquired my medical records from the time period when I had neurosurgery and those records revealed I definitely had Parinaud's. I relocated from the area where I had the surgery and had to find new doctors, including an opthamologist, neurologist, and neurosurgeon. Of course, they always do neurological/eye tracking tests and I'd always have difficulty with the upward gaze.