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Parino syndrome - why there is paralysis of the vertical eye?
Parino syndrome( vertical paralysis, spinal midbrain syndrome) - the lack of the ability to look in the other direction, namely up or down.
In most cases it is a manifestation of the developing tumor of the epiphysis, squeezing the center of the vertical view. It develops at any age, mostly females.
Causes and mechanism of development of
The disorder is a consequence of direct damage to the nervous tissue or complication of trophic disturbances and oxygen delivery due to abnormalities of vascular development, obstruction of the arterial thrombus. In the risk zone are:
- patients with benign or malignant neoplasms that squeeze the nearest anatomical structures;
- women from thirty to fifty with a disease such as multiple sclerosis;
- patients with a history of cerebral stroke;
- those patients who have an infectious central nervous system infection or toxic poisoning with chemicals, radiation.
The accompanying diseases of the endocrine system, metabolic disturbances and blood supply disorders of vital organs worsen the person's well-being.
Paralysis is polyethiologic, due to the growth of the tumor the oculomotor nerve is squeezed, its functioning, nutrition is disturbed. A corresponding clinical picture is growing.
Structure and function of the medulla and midbrain:
Clinical picture of
In addition to complaints about the inability to look up, there is a development of nystagmus, a narrowing of the pupil depending on the position of the subject on which the sight is focused. Externally, the position of the eyes is almost fixed, the upper eyelids lag behind when blinking. Rarely, the clinical picture is supplemented by imbalance.
With the development of infection, intoxication, fever, malaise, chills, headaches, weakness and fatigue, and disability can occur.
Diagnosis and treatment
Diagnosis is based on complaints and findings during a general examination. Laboratory methods are effective only in the case of damage to the nervous tissue by pathogenic microorganisms, in which case signs of inflammation are noted in the blood test.
Instrumental diagnosis is based on a complete visualization of the structure of the brain. With the help of magnetic resonance and computed tomography, the presence or absence of benign and malignant neoplasms of the brain is confirmed or refuted.
Electroencephalography is rarely prescribed and only for the purpose of differential diagnosis.
Therapy involves the elimination of the cause of the development of the Parino syndrome. Tumors are removed by surgery with radical or mini-access, the development of microflora is stopped by antibacterial drugs in combination with anti-inflammatory drugs.
Two-sided dissection of the lower rectus muscle restores the movement of the eyeball.
Consequences and Forecast
In most cases, the prognosis is favorable, the oculomotor nerve recovers functions, the quality of life improves significantly.
Complications are more associated with the etiology, - benign tumors tend to malignant( malignant), pathogenic pathogens in the absence of therapy spread to other areas of the central nervous system, possibly the formation of abscesses.