Parinaud Syndrome in a Patient With Microangiopathic Lesions in the Bilateral Gangliocapsular Region and Left Thalamus.

Parinaud syndrome, which most commonly involves the dorsal midbrain, has classical features of upward gaze paralysis, convergence-retraction nystagmus, and pupillary light near dissociation. A 62-year-old male presented to the Eye department with diminution of vision and symptoms of dry eye with associated difficulty in walking. Examination revealed nystagmus while performing convergence test. An MRI revealed lesions in the thalamic and gangliocapsular regions. Microangiopathies involving the thalamus and gangliocapsular region can lead to Parinaud syndrome. In our case, microangiopathies were most probably hypertensive.