From the GPnotebook:

Parinaud's ophthalmoplegia is the paralysis of conjugate movement that is associated with midbrain lesions.

The clinical features are:

• a loss of vertical gaze
• nystagmus on attempted convergence
• pseudo-Argyll-Robertson pupils (large pupils with sluggish reaction to light)

Bilateral papilloedema is common.

The causes of Parinaud's ophthalmoplegia include:

• pinealoma and other tumours affecting the mid-brain
• multiple sclerosis
• vascular lesions