The case of a 60yearold male patient with sudden, painless visual impairment in the left eye le, and a medical history of old optic nerve atrophy in his right eye re was described. We report a patient with the ophthalmic features of the foster kennedy syndrome from meningiomatosis. These findings suggested foster kennedy syn drome, in which an anterior intracranial mass directly compresses the ipsilateral optic nerve, causing atrophy, and. B fundus picture of the left eye showing disc oedema with tortuosity of the. Foster kennedy syndrome jama neurology jama network. He gives his name to foster kennedy syndrome, the kaplan kennedy test and kennedy s syndrome. Most masses are neoplastic, and meningiomas are the most prevalent lesions. Mass lesions accounting for foster kennedy syndrome are frequently located in the olfactory groove, falx cerebri, sphenoid wing, or subfrontal region 2. This case is termed pseudo foster kennedy with indirect compressive optic neuropathy due to brain displacement. It is characterised by the presence of ipsilateral optic atrophy, contralateral papilloedema and ipsilateral anosmia. Foster kennedy syndrome fks is a relatively rare clinical entity, first described by kennedy f.
A large frontal lobe, olfactory groove, or medial third sphenoidal wing tumor, usually a meningioma, creates this syndrome. Pituitaryadenoma presenting as fosterkennedy syndrome. Pseudo foster kennedy syndrome has been described in a number of conditions like naion, optic neuritis, and optic disc hypoplasia. A case of foster kennedy syndrome without frontal lobe or. Foster kennedy syndrome due to meningioma growth during.
Other reported mass lesions causing foster kennedy syndrome. View academics in foster kennedy syndrome on academia. Not only did he describe the constellation of findings before. In this report, the author presents a case of metastastic cerebral tumor with foster. Pseudo foster kennedy syndrome due to diabetic papillopathy author. Although exact localization should be aided by other clues, foster kennedy syndrome hints a disorder of visual pathways and prompts further neuroradiologic and ophthalmologic evaluations.
A symptom complex of unilateral optic atrophy with central scotoma and contralateral papilloedema was described by schultzsehden in. He was a british neurologist, who spent the majority of his working life in america 18841952. This syndrome is due to optic nerve compression, olfactory nerve compression, increased intracranial pressure secondary to a mass such as meningioma or plasmacytoma usually an olfactory groove meningioma resulting in optic atrophy in the ipsilateral eye, optic disc edema in the contralateral eye, central scotoma in the ipsilateral eye and ipsilateral anosmia. The foster kennedy syndrome originally was described as a meningioma of the olfactory groove may implicate the olfactory bulb and tract producing ipsiateral anosmia and then it extend posteriorly. Personal history robert foster kennedy figure was born in belfast, ireland, on feb 7, 1884.
Foster kennedy syndrome is uncommon, and numerous case series show its incidence to be less than 1% in conjunction with intracranial neoplasms. Wang, in handbook of clinical neurology, 2011 foster kennedy syndrome. An aggressive sphenoid wing meningioma causing foster. Fks is defined by presences of ipsilateral optic atrophy and contralateral papilledema, and occasionally anosmia. True foster kennedy syndrome is rare, but other causes of unilateral disc edema with contralateral optic pallor are more common.
He was one of the first doctors to use electroconvulsive. True foster kennedy syndrome is very rare, and is typically caused by an olfactory groove meningioma. Pseudo fosterkennedy syndrome pfks is characterized ophthalmoscopically by unilateral optic atrophy with contralateral optic disc edema. His grandfather was a professor at the royal university of ireland, belfast. Foster kennedy syndrome is a very rare syndrome which includes ipsilaterat optic atrophy and central scotoma, anosmia, contralateral papilledema, and. T he combination of ipsilateral optic atrophy and contralateral papilledema was emphasized as a syndrome characteristic of basal frontal tumor by foster. Casereport a 27yearold man presented to the casualty. Fosterkennedy syndrome is characterized by optic atrophy. Pseudofosterkennedy syndrome with optic nerve compression by the gyrus rectus. It is caused by compression of the ipsilateral optic nerve and olfactory nerve early, followed by secondarily increased intracranial pressure that produces disc edema in the only remaining intact optic nerve. Fosterkennedy syndrome project gutenberg selfpublishing. The case of a 60yearold male patient with sudden, painless visual impairment in the left eye le, and a medical history of old optic nerve. Optic nerve atrophy with contralateral optic disc edema.
First described in 1911, the foster kennedy syndrome also known as gowerspaton kennedy syndrome originates from a retrobulbar compressive optic neuropathy commonly caused by sphenoid wing meningioma, frontal lobe glioma, optic neuroglioma, olfactory glioma, chiasmal glioma, and. Because the pfk syndrome is a diagnosis of exclusion, neuroimaging plays an important role in distinguishing between the true foster kennedy syndrome and the pfk syndrome. Pseudo foster kennedy syndrome is defined as onesided optic atrophy with papilledema in the other eye but with the absence of a mass. A meningioma compressed one optic nerve to cause impaired visual function. Pdf on jan 23, 2019, simar rajan singh and others published foster kennedy syndrome find, read and cite all the research you need on. The foster kennedy syndrome although not a common phenomenon has been described in association with a wide variety of intracranial pathologies. Jan 15, 2021 although foster kennedy syndrome is sometimes called kennedy syndrome, 2 it should not be confused with kennedy disease, or spinal and bulbar muscular atrophy, which is named after william r. True foster kennedy syndrome is the combination of papilledema in one eye and pallor in the other eye due to a large mass lesion causing compressive optic neuropathy and increasing intracranial pressure. An aggressive sphenoid wing meningioma causing foster kennedy. Similarly, foster kennedy syndrome is well ensconced in the literature, and a topic we might use to test the fund of knowledge of our residents and fellows. Jan 23, 2019 foster kennedy syndrome in a 52yearold woman a fundus picture of the right eye showing optic disc pallor.
Pseudofoster kennedy syndrome as a rare presentation of. Download pdf foster kennedy syndrome was first described in 1911 by the neurologist robert foster kennedy, who characterized the disorder as compression of one optic nerve by a subfrontal meningioma, resulting in optic nerve head pallor, with increased intracranial pressure causing contralateral optic nerve head edema. Pseudofoster kennedy syndrome is described as unilateral optic disc swelling with contralateral optic atrophy in the absence of an. A case of foster kennedy syndrome without frontal lobe or anterior. Foster kennedy syndrome produced by myelomatous deposits. It is caused by compression of the ipsilateral optic nerve and olfactory nerve early, followed by secondarily increased intracranial pressure that.
Pseudofoster kennedy syndrome due to unilateral optic nerve. Foster kennedy syndrome is a very rare syndrome which includes ipsilateral optic atrophy and central scotoma, anosmia, contralateral papilledema, and, occasionally, ipsilateral proptosis. Foster kennedy syndrome is thought to be present in 1% to 2. Pseudo foster kennedy is described when there is pallor in one eye and disc edema in the contralateral eye in the absence of any intracranial mass. Ab foster kennedy was the first to correlate the signs of unilateral optic atrophy and contralateral papilledema to basofrontal expanding lesions and stress. Foster kennedy syndrome an overview sciencedirect topics.
Intracranial meningiomatosis causing foster kennedy syndrome. Foster kennedy syndrome in a case with retinitis pigmentosa. Foster kennedy syndrome is a cause of contralateral papilledema as a result of compressive optic neuropathy. Associated with various frontal lobe, olfactory groove, and anterior clinoid tumors, there is typically ipsilateral optic atrophy with contralateral papilledema. Pseudo fosterkennedy is usually a diagnosis of exclusion. A 36yearold man presented to the emergency department because of gradual blurring of vision in his right eye over 20 days and progressive loss of vision in the left eye over the previous eight months. In true foster kennedy syndrome unilateral disc swelling is caused by a tumor on the inferior surface of the frontal lobe, compressing the optic nerve on one side with papilledema contralaterally. Wepresentherethefirst caseofthe foster kennedy syndrome secondary to a pituitaryadenoma. In literature it has been usually reported in cases of benign intracranial hypertension, ischemic optic neu. He joined the junior staff of the national hospital for the paralyzed and epileptic in 1907. In the absence of an intracranial mass these findings may be labeled as pseudo foster kennedy syndrome, typically due to bilateral sequential optic.
Foster kennedy syndrome is a constellation of findings associated with tumors of the frontal lobe although foster kennedy syndrome is sometimes called kennedy syndrome, it should not be confused with kennedy disease, or spinal and bulbar muscular atrophy, which is named after william r. Dec 23, 20 true foster kennedy syndrome is the combination of papilledema in one eye and pallor in the other eye due to a large mass lesion causing compressive optic neuropathy and increasing intracranial pressure. Visa rene n, paredes carmona f arch soc esp oftalmol 2019 dec. Victor horsleys contribution to the foster kennedy syndrome. Pseudofosterkennedy syndrome with optic nerve compression. These findings suggested foster kennedy syndrome, in which an anterior intracranial mass directly compresses the ipsilateral optic nerve, causing atrophy, and. Convexity meningiomas compressed the superior sagittal sinus to impair cerebral venous drainage, increased intracranial pressure, and papilledema in the other eye. Diffusion tensor imaging in traumatic optic tract syndrome. Pseudo foster kennedy syndrome due to idiopathic intracranial hypertension.
Foster kennedy syndrome radiology reference article. They should be typewritten doublespaced on plain bond paper. A 52yearold woman presented to the ophthalmologist with complaints of decrease of vision in her right eye for the. Dr robert foster kennedy md frse 18841952 was an irishborn neurologist largely working in america. Although foster kennedy syndrome is sometimes called. Although the increase in intracranial pressure correlates with the size and loca. A 36yearold man presented to the emergency department because of gradual blurring of vision in his right eye over 20 days and progressive loss of vision in. Foster kennedy syndrome is characterized by optic atrophy on one side due to direct optic nerve mass lesion compression with contralateral papilledema. These have been termed pseudo foster kennedy syndrome, or pfk.
Clinical and computed tomographic findings in the foster. Esr and crp levels with positive temporal artery biopsy. The optic atrophy occurs on the side of tumor as a result of direct compression. To report a case of pseudo foster kennedy pfk syndrome and describe its clinical and paraclinical particularities, as well as the diagnostic difficulties and established treatment. Philadelphia the syndrome of atrophy of the optic nerve of one eye and papilledema in the other eye has come to be regardedas evidence of a tumor lying at the base of the frontal lobe. The presentation was characterized by sudden, painless and monocular va loss, with a previous similar episode. Peraltacalvo, journalcanadian medical association journal, year2011, volume183, pages. Foster kennedy syndrome due to meningioma growth during pregnancy. The largest series, performed in germany by tonnis in 1962 found 28 cases of foster kennedy syndrome in a series of 3,033 patients with intracranial tumors. The foster kennedy syndrome was originally described as the triad of optic atrophy, contralateral papilledema, and anosmia, caused by an olfactory groove meningioma or large frontal lobe tumors. Restricted diffusion in isolated superior ophthalmic vein thrombosis. Diagnose and manage pseudofoster kennedy syndrome american.
The foster kennedy syndrome is an unusual sign noted when a brain tumor, usually a meningioma, directly compresses the atrophic optic nerve and simultaneously produces intracranial. Diagnose and manage pseudofoster kennedy syndrome f. This case is termed pseudo foster kennedy with indirect compressive optic neuropathy due to brain displacement from a tumor distant from the optic nerve. Foster kennedy syndrome in a case of olfactory groove meningioma. With modern neuroimaging, the diagnosis is often made earlier and anosmia may not be present.
Fks is said to be due to an intracranial lesion causing. Foster kennedy syndrome is characterized by unilateral optic atrophy, central scotoma, anosmia, and contralateral disc edema kennedy, 1911. No doubt that advances in neuroimaging have contributed to its infrequent appearance, with earlier detection of an intracranial mass. Foster kennedy syndrome, named after neurologist robert foster kennedy 18841952, describes ipsilateral optic atrophy with contralateral papilledema from an intracranial mass. Foster kennedy syndrome wikimili, the best wikipedia reader.
First described in 1911, the foster kennedy syndrome also known as gowerspaton kennedy syndrome originates from a retrobulbar compressive optic neuropathy commonly caused by sphenoid wing meningioma, frontal lobe glioma, optic neuroglioma, olfactory glioma, chiasmal glioma, and craniopharyngioma. This case is termed pseudo foster kennedy with indirect compressive optic. A further note on the diagnostic value of retrobulbar neuritis in expanding lesions of the frontal lobes, with a report of this syndrome in a case of aneurysm of the right internal carotid artery. These findings can mimic the true fosterkennedy syndrome, but clinical features and presentation often can distinguish the two entities. The hospital, founded in 1860, was one of the earliest neurological institutes and rapidly established a global reputation on account of its. Careful attention to the ophthalmoscopic appearance of the left eye disclosed optic disk swelling in regions. Letters to the editor should be submitted as an original and two duplicates. Robert foster kennedy was born in belfast, educated at queens college, and qualified in medicine in 1906. Pseudofosterkennedy syndrome with optic nerve compression by.
Thus, because of the lack of expansive intracranial or intraorbital processes on the head mri scan, we had a case of pfk syndrome and papilloedema was deemed unlikely. Foster kennedy syndrome produced by myelomatous deposits in. Pseudo foster kennedy syndrome secondary to uncontrolled. Although foster kennedy is the name given to the syndrome localizing an intracranial tumour with respect to papilloedema, it is important to recognize how victor horsley was one of the strongest proponents in the usefulness of that sign. Foster kennedy described a triad of signs, consisting of ipsilateral optic atrophy, contralateral optic disc edema, and ipsilateral anosmia, as characteristic of a spaceoccupying lesion in the basofrontal area on the side of optic atrophy 1,2. Foster kennedy syndrome describes the clinical syndrome of unilateral optic atrophy with contralateral papilledema caused by an ipsilateral compressive mass. Foster kennedy syndrome in a 52yearold woman a fundus picture of the right eye showing optic disc pallor. Fosterkennedy syndrome an overview sciencedirect topics. Foster kennedy syndrome produced by myelomatous deposits in the skull br med j 1955. Foster kennedy syndrome is a constellation of findings associated with tumors of the frontal lobe. Pseudofoster kennedy syndrome due to idiopathic intracranial. We are hereby presenting a case of pseudo foster kennedy syndrome, which is a rare phenomenon in itself because of normal level of inflammatory markers i. Foster kennedy s syndrome fks is a rare neurological sign first described in 1911 by robert foster kennedy. Pseudofoster kennedy syndrome due to diabetic papillopathy.
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