Foster Kennedy syndrome
Encyclopedia
Foster Kennedy syndrome (also known as Gowers-Paton-Kennedy syndrome, Kennedy's phenomenon or Kennedy's syndrome) (not to be confused with Foster's Ice Cream) refers to a constellation of findings associated with tumors of the frontal lobe
Frontal lobe
The frontal lobe is an area in the brain of humans and other mammals, located at the front of each cerebral hemisphere and positioned anterior to the parietal lobe and superior and anterior to the temporal lobes...

.

Although "Foster Kennedy syndrome" is equated with "Kennedy syndrome", it should not be confused with Kennedy disease
Kennedy disease
Kennedy's disease or X-linked Spinal and Bulbar Muscular Atrophy or Spinobulbar Muscular Atrophy or X-Linked Bulbo-Spinal Atrophy is an X-linked recessive, slow progressing, neurodegenerative disease associated with mutation of the androgen receptor...

, which is named for W. 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.

Presentation

The syndrome is defined as the following changes:
  • optic atrophy in the ipsilateral eye
  • papilledema
    Papilledema
    Papilledema is optic disc swelling that is caused by increased intracranial pressure. The swelling is usually bilateral and can occur over a period of hours to weeks. Unilateral presentation is extremely rare....

     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
Intracranial pressure
Intracranial pressure is the pressure inside the skull and thus in the brain tissue and cerebrospinal fluid . The body has various mechanisms by which it keeps the ICP stable, with CSF pressures varying by about 1 mmHg in normal adults through shifts in production and absorption of CSF...

 (ICP) secondary to a mass (such as meningioma
Meningioma
The word meningioma was first used by Harvey Cushing in 1922 to describe a tumor originating from the meninges, the membranous layers surrounding the CNS ....

 or plasmacytoma
Plasmacytoma
Plasmacytoma refers to a malignant plasma cell tumor growing within soft tissue or within the skeleton. The skeletal forms usually have other occult tumors and frequently disseminate to multiple myeloma over the course of 5–10 years. The soft tissue forms most often occur in the upper respiratory...

, usually an olfactory groove meningioma). There are other symptoms present in some cases such as nausea
Nausea
Nausea , is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit. It often, but not always, precedes vomiting...

 and vomiting
Vomiting
Vomiting is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose...

, memory loss
Memory loss
Memory loss can be partial or total and it is normal when it comes with aging. Sudden memory loss is usually a result of brain trauma and it may be permanent or temporary. When it is caused by medical conditions such as Alzheimers, the memory loss is gradual and tends to be permanent.Brain trauma...

 and emotional lability (i.e. frontal lobe
Frontal lobe
The frontal lobe is an area in the brain of humans and other mammals, located at the front of each cerebral hemisphere and positioned anterior to the parietal lobe and superior and anterior to the temporal lobes...

 signs).

History

The syndrome was first extensively noted by Robert Foster Kennedy
Robert Foster Kennedy
Robert Foster Kennedy was an Irish-American neurologist.Foster Kennedy studied medicine at Belfast University and took his final exams at the Royal University of Ireland/Dublin...

 in 1911, a British neurologist
Neurologist
A neurologist is a physician who specializes in neurology, and is trained to investigate, or diagnose and treat neurological disorders.Neurology is the medical specialty related to the human nervous system. The nervous system encompasses the brain, spinal cord, and peripheral nerves. A specialist...

, who spent most of his career working in the United States of America. However, the first mention of the syndrome came from a William Gowers
William Gowers
William Gowers may refer to:*William Frederick Gowers, British colonial administrator*William Richard Gowers, Victorian era British neurologist*William Timothy Gowers, Fields Medal-winning British mathematician...

in 1893. Schultz-Zehden described the symptoms again in 1905. A later description was written by Wilhelm Uhthoff in 1915.

Treatment and prognosis

The treatment, and therefore prognosis, varies depending upon the underlying tumour.
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