HENRI PARINAUD (1844 to 1905) had an unusual opportunity to study disorders of eye movement since he served as ophthalmologist to Charcot's neurological service at the Salpêtrière.1 As a result of this experience, Parinaud became one of the first to distinguish between central and peripheral ocular paralyses.
Among the types of central paralysis that he described was paralysis of ocular convergence accompanied by paralysis of vertical eye movements.2-5 Parinaud postulated that the lesion accounting for this form of paralysis might affect the corpora quadrigemina instead of directly involving the oculomotor nuclei, and this hypothesis has subsequentlybeen confirmed. However, he failed to mention a useful physical sign of a supranuclea lesion, the preservation of the vestibuloocular reflexes, or "doll's head" movements, which tend to be abolished with nuclear and peripheral lesions.
Parinaud's syndrome, now defined as a paralysis of conjugate vertical eye movements (especially upgaze), with varying degrees of