Henri Parinaud

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Biography

• 1844 – Born May 1 in Bellac, Haute-Vienne, France, to a working-class family. His father, a locksmith, died when Henri was 19.
• 1857–1863 – Attended the Ajain Seminary.
• 1865 – Commenced medical studies in Limoges; interned under Dr. Bardinet.
• 1868 – Awarded medical merit prize.
• 1869 – Moved to Paris for further medical studies.
• 1870 – Served as Red Cross medical officer during the Franco-Prussian War; demonstrated bravery during evacuations at Metz and Châteaudun. Later decorated with the Ordre national de la Légion d’honneur by Léon Gambetta.
• 1877 – Completed doctoral thesis on childhood meningitis and papilloedema, attributing the condition to obstructive hydrocephalus rather than optic neuritis. This work attracted the attention of Jean-Martin Charcot (1825–1893), who appointed him ophthalmologist at the Salpêtrière Neurological Service.
• 1883 – Published Paralysie des mouvements associés des yeux, foundational to the later concept of Parinaud syndrome.
• 1886 – Published observations on paralysis of ocular convergence in Brain journal.
• 1889 – With Xavier Galezowski (1832–1907), described infectious conjunctivitis with regional lymphadenitis now recognized as Parinaud oculoglandular syndrome.
• 1898 – Published La vision. Étude physiologique.
• 1899 – Published Le strabisme et son traitement.
• 1904 – Published Stéréoscopie et projection visuelle. Death of his wife led to profound personal grief.
• 1905 – Died in March in Paris from bronchopneumonia, following a period of depression. Survived by three daughters, later tutored by Joseph Babinski (1857–1932).

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Medical Eponyms

Parinaud Syndrome (Dorsal Midbrain Syndrome)

Supranuclear vertical gaze palsy with convergence-retraction nystagmus and pupillary abnormalities; first described by Henri Parinaud in in Paralysie des mouvements associés des yeux (1883).

Dans l’étude des paralysies motrices de l’œil, on semble admettre que la lésion est toujours périphérique… Mais, le plus souvent, la lésion est centrale…

In the study of motor paralysis of the eye, one seems to assume that the lesion is always peripheral… But, more often, the lesion is central…

Parinaud 1883

1903 – H. Koerber described convergence-retraction movements of the globes in Über drei Fälle von Retraktionsbewegung des Bulbus (Nystagmus retractorius)

1911 – Robert Salus reports acquired convergence-retraction movements in Über erworbene Retraktionsbewegungen der Augen

1933 – A. Elschnig further characterises convergence-retraction nystagmus as a cerebral focal sign in Nystagmus retractorius, ein cerebrales Herdsymptom. Med Klin (Munich). 1933;29:1134.

1905 – The term ‘syndrome de Parinaud‘ was introduced in French literature to describe the constellation of vertical gaze palsy and associated features. Osler initially used ‘Syndrome of Parinaud‘ in his Modern Medicine series (1906), before Parinaud’s syndrome became the more common term

1980s–2000s – Neuroimaging and neuroanatomical studies clarify the role of the riMLF, posterior commissure, and interstitial nucleus of Cajal in the pathophysiology of the syndrome. The term pretectal syndrome gains support as a descriptive alternative.

Definitions of Parinaud syndrome vary considerably across neurology literature; Parinaud himself did not propose a formal “syndrome.” Some authors advocate replacing the eponym with the more descriptive term pretectal syndrome.

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Parinaud Oculoglandular Syndrome

Parinaud oculoglandular syndrome (POGS) is a rare unilateral granulomatous conjunctivitis associated with ipsilateral preauricular or cervical lymphadenopathy, often accompanied by fever and systemic symptoms. The syndrome typically presents with a red, irritated, painful eye, non-purulent conjunctivitis, and regional lymphadenitis. It is almost invariably unilateral and affects both sexes, with a higher incidence in children and young adults.

POGS is most frequently a complication of cat-scratch disease (CSD) caused by Bartonella henselae, but has also been associated with other infectious agents, including Francisella tularensis (tularemia), Herpes simplex virus, Paracoccidioides brasiliensis, and Sporothrix schenckii. Prognosis is generally excellent, with most cases resolving spontaneously within 2–4 months; antimicrobial therapy is indicated in immunocompromised or systemically unwell patients.

The eponym honours Henri Parinaud (1844–1905), who first described the condition in 1889. The American ophthalmologist Harold Gifford (1858–1929) later proposed the eponymic designation. The syndrome should not be confused with Parinaud’s syndrome, a neurological disorder affecting vertical gaze, also named after Parinaud.

1889 – Parinaud, along with Xavier Galezowski (1832–1907), publishes Conjunctivite infectieuse transmise par les animaux in Annales d’oculistique, describing unilateral conjunctivitis with adjacent lymphadenopathy linked to animal exposure. Parinaud considered the infection to be of animal origin partly on account of its isolated and unusual character; and partly because one of his patients was the wife of a butcher, while another lived in a house in another part of which meat was stored

1898 – Harold Gifford (1858–1929) suggests the eponymic designation “Parinaud’s conjunctivitis”

In designating this disease, I think it is best to waive the qnestion of an animal origin and simply call it Parinaud’s conjunctivitis, because he was undoubtedly the first to recognize and describe the main complex of symptoms.

Gifford 1898

1921 – Francisella tularensis, the causative agent of tularemia, is isolated and described, expanding the known infectious causes of POGS.

1924 – Bulgarian ophthalmologist, Professor Konstantin Pashev proposed the term, Parinaud’s syndrome, but as the term was used to designate a supranuclear paralysis of associated movements of the eyeballs, the term was not taken up.

1930s–1950s – Recognition grows that POGS can arise from other bacterial, fungal, and viral agents.

1990s – Molecular and serological methods, including PCR, improve detection of Bartonella henselae, solidifying its role as the primary cause of POGS in CSD.

2015 – Arjmand et al. publish a comprehensive review on Parinaud oculoglandular syndrome, updating clinicians on diagnostic strategies and therapeutic approaches.

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Key Medical Contributions

• First to associate papilloedema in childhood meningitis with obstructive hydrocephalus.
• Early work on ocular motility disorders and gaze paralysis.
• Studies of photoreceptor physiology and visual purple.
• Described ocular manifestations of multiple sclerosis and hysteria.
• Contributions to surgical techniques for strabismus, cataract, glaucoma, and ptosis.

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Major Publications

• Parinaud H. Paralysie des mouvements associés des yeux. Archives de Neurologie 1883; 5: 145–172 [Parinaud syndrome]
• Parinaud H. Paralysie de la convergence. Bull Mem Soc Franc Ophthal 1886; 4: 23-33
• Parinaud H. Paralysie de la convergence. Annales d’oculistique 1886; 95: 205-206.
• Parinaud H. Paralysis of the movement of convergence of the eyes. Brain 1886; 9: 330-341
• Parinaud H, Galezowski X. Conjunctivite infectieuse transmise par les animaux. Annales d’oculistique, Bruxelles, 1889; 101: 252-253. [Parinaud Oculoglandular Syndrome]
• Parinaud H. La Vision; étude physiologique. 1898
• Parinaud H. Le strabisme et son traitement. 1899
• Parinaud H. Stereoscopie et projection visuelle. 1904
• Erick P. Légende D’Une Marionnette. Ricordi, Paris, 1904.

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References

Biography

• Ouvrier R. Henri Parinaud and his syndrome. Med J Aust. 1993 May 17;158(10):711, 714
• Ouvrier R. Henri Parinaud (1844-1905). J Neurol. 2011 Aug;258(8):1571-2.
• Poirier PJ. Henri Parinaud (1844–1905): Pionnier de l’ophtalmologie française. Pratiques en Ophtalmologie. 2011;5(46):2–7.

Eponymous terms

Parinaud Oculoglandular Syndrome

• Gifford H. Five cases of Parinaud’s conjunctivitis. American journal of ophthalmology. 1898; 15(7): 193
• Pascheff C. The differential diagnosis between Parinaud’s conjunctivitis and conjunctivitis necroticans infectiosa. Br J Ophthalmol. 1924 Jan;8(1):25-32.
• Gifford H. Some historical data on Parinaud’s conjunctivitis. Br J Ophthalmol. 1924 Jul;8(7):350.
• Cassady JV, Culbertson CS. Cat-scratch disease and Parinaud’s oculoglandular syndrome. AMA Arch Ophthalmol. 1953 Jul;50(1):68-74. 
• Arjmand P, et al. Parinaud Oculoglandular Syndrome 2015: Review of the Literature and Update on Diagnosis and Management. Longdom. 2015.
• Albert DM, Salman AR, Winthrop KL, Bartley GB. The Continuing Ophthalmic Challenge of Bartonella henselae. Ophthalmol Sci. 2021 Jul 27;1(3):100048.
• Chang V. Parinaud Oculoglandular Syndrome. American Academy of Ophthalmology EyeWiki.

Parinaud syndrome

• Koerber H. Über drei Fälle von Retraktionsbewegung des Bulbus (Nystagmus retractorius). Die Ophthalmologische Klinik. 1903; 7: 65.
• Gaussel A. La paralysie des mouvements associés de latéralité des yeux dans les affections du cervelet, des tubercules quadruuueaux et de la protubérance. Revue de médecine. 1905: 809-843
• Salus R. Über erworbene Retraktionsbewegungen der Augen. Archiv für Augenheilkunde. 1911; 68: 61–76.
• Elschnig A. Nystagmus retractorius, ein cerebrales Herdsymptom. Medizinische Klinik. 1933; 29: 1134.
• Pierrot-Deseilligny CH, Chain F, Gray F, Serdaru M, Escourolle R, Lhermitte F. Parinaud’s syndrome: electro-oculographic and anatomical analyses of six vascular cases with deductions about vertical gaze organization in the premotor structures. Brain. 1982 Dec;105 (Pt 4):667-96.
• Pearce JM. Parinaud’s syndrome. J Neurol Neurosurg Psychiatry. 2005 Jan;76(1):99.
• Roper-Hall G. Historical vignette: Henri Parinaud (1844-1905): French ophthalmologist and pioneer in neuroophthalmology. Am Orthopt J. 2014;64:126-33.
• Barbato F, Allocca R, Bosso G, Numis FG. Parinaud’s syndrome: a stroke chameleon. Intern Emerg Med. 2024 Jan;19(1):145-146.

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