Symptoms Related to the Superior Colliculus

Either I've started over-calling pineal lesions and my attendings are letting it slide, or we've had a rash of pineal masses that touch the superior colliculus.

The superior colliculus receives retinal fibers and sends out fibers to motor centers responsible for directing eye movement, head turn, and arm-reach. Dysfunction of the superior colliculus is seen in Parinaud syndrome and progressive supranuclear palsy.

Tumors of the pineal gland can compress the superior colliculus and cause Parinaud syndrome: paralysis of upward gaze, convergence retraction nystagmus, light-near dissociation of the pupils (Argyll-Robertson pupil), and lid retraction (Collier sign).

Progressive supranuclear palsy is a degenerative disorder that affects the basal ganglia and brainstem. It is one of the Parkinson plus diseases, the plus in this case involves eye movements, the most distinctive being vertical gaze palsy.

References

Eric R Eggenberger and Zeba F Vanek. Progressive supranuclear palsy. eMedicine; Feb 20, 2007.