Foster Kennedy syndrome
| Foster–Kennedy syndrome | |
|---|---|
 | |
| Frontal lobe(on the right) | |
| Specialty | Neurology  |
Foster–Kennedy syndrome (also known as Gowers–Paton–Kennedy syndrome, Kennedy's phenomenon or Kennedy's syndrome) refers to a constellation of findings associated with tumors of the frontal lobe.[1]
Although Foster–Kennedy syndrome is equated with Kennedy syndrome,[2] it should not be confused with Kennedy disease, which is named for William R. Kennedy.
Pseudo-Foster–Kennedy syndrome is defined as one-sided optic atrophy with papilledema in the other eye but with the absence of a mass.[3]
Presentation
The syndrome is defined as the following changes:
- optic atrophy in the ipsilateral eye
- disc edema in the contralateral eye
- central scotoma (loss of vision in the middle of the visual fields) in the ipsilateral eye
- anosmia (loss of smell) ipsilaterally
This syndrome is due to optic nerve compression, olfactory nerve compression, and increased intracranial pressure (ICP) secondary to a mass (such as meningioma or plasmacytoma, usually an olfactory groove meningioma).[4][5] There are other symptoms present in some cases such as nausea and vomiting, memory loss and emotional lability (i.e., frontal lobe signs).[5]
Diagnosis
Brain tumor can be visualized very well on CT scan, but MRI gives better detail and is the preferred study. While awaiting surgical removal, treat any increased intracranial pressure with high-dose steroids (i.e., dexamethasone). Clinical localization of brain tumors may be possible by virtue of specific neurologic deficits or symptom patterns. Tumor at the base of the frontal lobe produces inappropriate behavior, optic nerve atrophy on the side of the tumor, papilledema on the other side, and anosmia (Foster- Kennedy syndrome). [6]
Treatment and prognosis
The treatment, and therefore prognosis, varies depending upon the underlying tumour.[5]
History
The syndrome was first extensively noted by Robert Foster Kennedy in 1911, a British neurologist, who spent most of his career working in the United States of America.[7] However, the first mention of the syndrome came from a William Gowers in 1893. Schultz-Zehden described the symptoms again in 1905. A later description was written by Wilhelm Uhthoff in 1915.[8]
References
- ^ "Kennedy syndrome" at Dorland's Medical Dictionary
- ^ "Foster Kennedy syndrome" at Dorland's Medical Dictionary
- ^ Bansal S, Dabbs T, Long V (2008). "Pseudo-Foster Kennedy Syndrome due to unilateral optic nerve hypoplasia: a case report". J Med Case Reports. 2: 86. doi:10.1186/1752-1947-2-86. PMC 2278154. PMID 18348732. Retrieved 2008-08-13.
{{cite journal}}: CS1 maint: unflagged free DOI (link) - ^ Longmore, Murray; Ian Wilkinson; Tom Turmezei; Chee Kay Cheung (2007). Oxford Handbook of Clinical Medicine (7th ed.). Oxford University Press. p. 690. ISBN 0-19-856837-1.
- ^ a b c Willacy, Hayley. "Foster Kennedy syndrome". Retrieved 2008-08-13.
- ^ Cite error: The named reference
Kaplan USMLE step 2 CK Lecture Notes 2018, Surgerywas invoked but never defined (see the help page). - ^ Thorofare, NJ (1911). Kennedy F; Retrobulbar neuritis as an exact diagnostic sign of certain tumors and abscesses in the frontal lobe. American Journal of the Medical Sciences.
- ^ "Kennedy's syndrome". Retrieved 2008-08-13.