Foster-Kennedy syndrome vs Pseudo-Foster-Kennedy syndrome

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Identifier foster_kennedy_vs_pseudo_foster_kennedy
Title Foster-Kennedy syndrome vs Pseudo-Foster-Kennedy syndrome
Subject Tumor; Intracranial Pressure; Atrophy; Papilledema
Creator Andrew G. Lee, MD, Chairman, Department of Ophthalmology, The Methodist Hospital, Houston, TX, Professor of Ophthalmology, Weill Cornell Medicine; Vivian Wang, Baylor College of Medicine, Class of 2021
Description Summary • True Foster-Kennedy syndrome o Presentation -Optic disc edema in one eye + optic atrophy in the other eye o Cause -Tumor pressing on ipsilateral optic nerve, causing optic atrophy in one eye -Increased intracranial pressure from tumor causes papilledema in the other eye -Tumor is most commonly slow-growing, enlarging anterior cranial fossa meningioma • Usually frontal, olfactory, or sphenoid wing meningioma • Pseudo-Foster-Kennedy syndrome o Also presents with optic atrophy in one eye and optic disc edema in the other eye o How to differentiate -Usually there is a history of loss of vision in the optic atrophy eye before -Most common cause of Pseudo-Foster-Kennedy syndrome is bilateral and sequential NAION (non-arteritic anterior ischemic optic neuropathy) • Had optic atrophy from first event • One year or two later, present with optic disc edema as second event o So, the eye with vision loss due to optic disc edema is NOT papilledema but recurrent NAION. • Management o True Foster-Kennedy syndrome -MRI o Pseudo-Foster-Kennedy syndrome -no MRI, treat risk factors for NAION o If you cannot elucidate history of bilateral and sequential optic neuropathy with disc edema -MRI [Transcript of video] "Today we're going to be talking about the Foster-Kennedy syndrome and the Pseudo-Foster-Kennedy syndrome. The true Foster-Kennedy syndrome is when we have optic disc edema in one eye, and in the other eye we have optic atrophy. And the reason this is a Foster-Kennedy syndrome is because we have a tumor pressing on the ipsilateral optic nerve. And the tumor is so big that it is causing increased intracranial pressure. And that increased intracranial pressure is causing unilateral papilledema in the fellow eye. And the most common causes of Foster-Kennedy syndrome are frontal, olfactory, and sphenoid wing meningioma. So FOS in Foster. Those are the tumors that can get big enough over a long enough period of time to produce the finding of optic atrophy in one eye plus papilledema in the fellow eye from a slow-growing, enlarging anterior cranial fossa meningioma. However, it could be the Pseudo-Foster-Kennedy syndrome. And the way to differentiate the true Foster-Kennedy syndrome from the Pseudo-Foster-Kennedy syndrome is they both have optic atrophy in one eye and optic disc edema in the other eye. But as opposed to the true Foster-Kennedy syndrome, usually there's a history that they had loss of vision in the optic atrophy eye before, like a year ago they had NAION. And now, this eye has vision loss with the swollen optic nerve, which is not papilledema but just recurrent NAION. So, the most common cause of the Pseudo-Foster-Kennedy syndrome is bilateral but sequential nonarteritic anterior ischemic optic neuropathy, where they had optic atrophy from the first event and now, they have a swollen disc one year later or two years later from the second event. An MRI scan needs to be performed for the true Foster-Kennedy syndrome, and if you can't elucidate the history of bilateral sequential optic neuropathy with disc edema, most commonly NAION, you probably should do an MRI scan on the Pseudo-Foster-Kennedy also. If however the chart clearly shows that was NAION last year and now is NAION this year, we don't have to do MRI on that. For this case, you have to treat the risk factors for NAION. So, you should now be able to differential true Foster-Kennedy syndrome from Pseudo-Foster-Kennedy syndrome, even though both patients present with optic atrophy in one eye and a swollen disc in the other."
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2019-10
Format video/mp4
Rights Management Copyright 2019. For further information regarding the rights to this collection, please visit:
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Language eng
ARK ark:/87278/s6992zjx
Setname ehsl_novel_lee
Date Created 2019-10-10
Date Modified 2019-10-15
ID 1469297
Reference URL