Children with dorsal midbrain syndrome as a result of pineal tumors

Mary Ellen Hoehn, Julie Calderwood, Thomas O'Donnell, Gregory Armstrong, Amar Gajjar

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background Dorsal midbrain syndrome (also known as Parinaud syndrome and pretectal syndrome) is a well-known complication of tumors of the pineal region. However, there are few reports regarding outcomes, especially in children. The purpose of this study was to report the ophthalmic outcomes in a group of children with pineal tumors treated at a single institution. Methods The medical records of pediatric patients diagnosed with pineal region tumors and evaluated at our ophthalmology clinic were studied retrospectively. Descriptive statistics were used to assess rate of dorsal midbrain syndrome, defined as one or more of the following: limitation of upgaze, pupillary light-near dissociation, and convergence retraction nystagmus. Treatment outcomes were recorded. Results A total of 35 subjects (age range, 5 months to 20 years) were included, 18 (51%) of whom were found to have dorsal midbrain syndrome. Of those 18, 16 patients (89%) had limitation of upgaze, 15 (83%) had pupillary light-near dissociation, and 9 (50%) had convergence-retraction nystagmus. Convergence insufficiency was noted in 5 patients (28%); exotropia (either intermittent or constant), in 9 (50%). Improvement in dorsal midbrain syndrome findings following treatment was seen in 7 of 17 patients (41%), but only 2 (12%) experienced complete resolution. Treatment consisted of surgery, radiation, and/or chemotherapy. Conclusions In our study cohort of children with pineal tumors have a high incidence of dorsal midbrain syndrome. Most cases had residual findings after treatment.

Original languageEnglish (US)
Pages (from-to)34-38
Number of pages5
JournalJournal of AAPOS
Volume21
Issue number1
DOIs
StatePublished - Feb 1 2017
Externally publishedYes

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Pinealoma
Mesencephalon
Pathologic Nystagmus
Ocular Motility Disorders
Exotropia
Light
Ophthalmology
Medical Records
Cohort Studies
Therapeutics
Radiation
Pediatrics
Drug Therapy
Incidence

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Ophthalmology

Cite this

Children with dorsal midbrain syndrome as a result of pineal tumors. / Hoehn, Mary Ellen; Calderwood, Julie; O'Donnell, Thomas; Armstrong, Gregory; Gajjar, Amar.

In: Journal of AAPOS, Vol. 21, No. 1, 01.02.2017, p. 34-38.

Research output: Contribution to journalArticle

Hoehn, Mary Ellen ; Calderwood, Julie ; O'Donnell, Thomas ; Armstrong, Gregory ; Gajjar, Amar. / Children with dorsal midbrain syndrome as a result of pineal tumors. In: Journal of AAPOS. 2017 ; Vol. 21, No. 1. pp. 34-38.
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