The Foster-Kennedy syndrome is characterized by a combination of increased intracranial pressure and compressed optic nerve. The disease is often due to neoplasms, especially in the frontal lobe of the brain. The causal treatment is therefore primarily aimed at removing the tumor.
What is Foster-Kennedy Syndrome?
According to BITTRANSLATORS, Foster-Kennedy syndrome is a disease that is characterized by two features: increased pressure in the brain and compression of an optic nerve. Medicine calls intracranial pressure the pressure that prevails in the brain. It includes both the pressure of the blood vessels and the pressure of the fluid in the tissue.
In a healthy person, the intracranial pressure is between 5 and 15 mmHg. Robert Foster Kennedy first described the disease in 1911. The neurologist lived in both Ireland and the United States and was one of the first doctors to use electroconvulsive therapy on psychotic patients. He also tried to explain war neuroses and in 1940 became President of the American Neurological Association.
A tumor in the brain is responsible for the development of Foster-Kennedy syndrome. The new formation sits at the base of the frontal lobe, which forms the frontal area of the cerebrum. The frontal lobe controls movements and controls cognitive processes. It also influences higher psychological abilities such as social behavior, creativity, self-control and action planning.
The new formation itself damages the body indirectly in Foster-Kennedy syndrome; the symptoms arise as the tumor grows and, as a result, requires more space. It presses on the optic nerve, which is on the same side as the tumor. The mass compresses the optic nerve, which interrupts the supply of nutrients. It then atrophies, that is, it withers away.
Medicine calls this symptom ipsilateral (on the same side) optic atrophy. At the same time, a congestive papilla forms on the other side (contralateral). This is an edema that forms where the optic nerve touches the retina. The growing tumor also ensures that intracranial pressure increases: it changes the relationship between volume and mass in the skull.
Symptoms, ailments & signs
The signs of Foster-Kennedy syndrome are mainly triggered by increased intracranial pressure. If it rises, symptoms such as nausea and vomiting manifest themselves, which those affected often initially confuse with acute gastrointestinal complaints. In addition, there are potentially vigilance disorders, headaches, fatigue and quantitative disorders of consciousness up to coma. The heartbeat may slow down.
Medicine speaks of bradycardia when the rate drops to less than 60 heartbeats per minute in an adult. At the same time, blood pressure can rise. Bradycardia and high blood pressure are caused by the so-called Cushing reflex. The increasing intracranial pressure affects the blood flow to the brain. This condition is critical for the human body because the nerve and ganglion cells no longer receive enough oxygen and other nutrients.
If the cells are undersupplied for too long, they eventually die. You cannot regenerate. To avoid this, the Cushing reflex comes into play: it increases blood pressure in order to balance the relationship between blood and intracranial pressure. The blood pressure can reach peak values of 300 mmHg (systolic).
It may show up as headache, dizziness, nausea, and difficulty sleeping, but it can appear without symptoms. Since Foster-Kennedy syndrome also affects the optic nerves, those affected often suffer from visual disturbances.
Diagnosis is done by doctors determining the two cardinal symptoms of Foster-Kennedy syndrome. A measuring probe in the tissue can measure the intracranial pressure. However, this measurement is relatively prone to errors, as the intracranial pressure can fluctuate greatly in the individual areas of the tissue. In relation to this, the examination of the optic nerve is easier. Optical procedures are able to reveal its condition.
A detailed anamnesis helps in the diagnosis of Foster-Kennedy syndrome as well as the diagnosis of the individual symptoms. Imaging procedures such as CT or MRI can make the tumor visible. Depending on the type of neoplasm and the individual conditions, healing is possible if the tumor can be completely removed.
As a rule, Foster-Kennedy syndrome has complications such as vomiting, headaches or nausea, which are common in many clinical pictures. Because of this, Foster-Kennedy Syndrome is not directly identified. The affected person often suffers from stomach pain or from symptoms of a gastrointestinal infection.
Fatigue also occurs, which can rarely be compensated for with sleep. If Foster-Kennedy syndrome progresses and is not treated, impaired consciousness will manifest. In the worst case, these can slow the heartbeat and lead to a comatose state. Due to the syndrome, the brain is no longer supplied with sufficient oxygen, which is why certain nerves can be damaged and, in the worst case, die.
This can lead to disabilities or mental impairments of the patient. Often there are also visual disturbances and insomnia. In many cases, the tumor can be removed so that Foster-Kennedy syndrome can be treated completely.
In the event of a coma, the patient is usually kept alive and given medication. Life expectancy drops sharply due to Foster-Kennedy Syndrome. If the tumor has already spread in the body, the syndrome can no longer be treated and leads to death.
When should you go to the doctor?
Since Foster-Kennedy syndrome is the occurrence of a tumor, medical treatment and examination is always necessary. In this way the premature death of the person concerned can be avoided. A doctor should be consulted if the person concerned suffers from persistent vomiting and nausea for no particular reason.
Severe headaches, persistent tiredness and complaints in the stomach and intestines can also indicate Foster-Kennedy syndrome and must always be examined. Affected people can also lose consciousness and often suffer from a slow heartbeat.
At the same time, there is also high blood pressure. If this remains high over a longer period of time, a visit to the doctor is also recommended. Symptoms of Foster-Kennedy syndrome also include visual disturbances, insomnia or severe dizziness.
Diagnosis and treatment of the syndrome are usually done in a hospital. The earlier the tumor is discovered and can be removed, the higher the likelihood of a positive course of the disease. Since the syndrome can lead to psychological complaints in the patient and his relatives, treatment with a psychologist is also advisable.
Treatment & Therapy
Therapy for Foster-Kennedy Syndrome depends on various factors. In principle, doctors have to weigh up which form of treatment or which combination of therapies makes the most sense on a case-by-case basis. For example, the size of the tumor, its location and its behavior play a major role. The benefits and risks of each treatment option vary widely between different individuals.
Surgeons can remove the neoplasm if there is no contraindication and the tumor is easily accessible. An appropriate operation separates out the diseased tissue as carefully as possible without removing healthy brain tissue as well. Radiation is another option. If the appropriate conditions are met, a combination of the two forms of therapy may also make sense. In addition, doctors treat the individual symptoms that occur in the context of Foster-Kennedy syndrome.
Quantitative disorders of consciousness are a particular challenge; Patients who are in a coma require intensive care. But even less severe impaired consciousness can make it necessary for those affected to rely on help from other people – for example when taking medication on a regular basis.
Outlook & forecast
Foster-Kennedy syndrome is a result of a tumor in the human brain. Since it is not a causal disease, the prognosis of the syndrome depends on the treatability of the underlying tumor. Without the use of medical care, the brain tumor will continue to grow. In addition, the cancer cells can spread through the human bloodstream and lead to the spread of the cancer. The premature death of the person concerned is ultimately the result.
If the brain tumor forms in an unfavorable position or if the cancer stage is already very advanced, adequate medical care can often no longer be guaranteed. The focus of therapy in these patients is on pain relief.
If the brain tumor is detected and treated at an early stage, there is a prospect of a cure. The tumor is removed in a surgical procedure. This is followed by cancer therapy so that no new cancer cells form. If the treatment goes without complications, recovery can occur. Nevertheless, sequelae and a longer healing process can be expected. Lifelong impairments remain in many patients. In addition, despite all efforts, a recurrence of the brain tumor and thus Foster-Kennedy syndrome can occur at any time.
There is no direct prevention of Foster-Kennedy syndrome. Detecting the disease early on can avoid more serious complications. If the tumor has already expanded significantly, this may make it difficult to remove or even make it impossible.
Follow-up care for Foster-Kennedy syndrome depends on whether the causative tumor can be treated and successfully removed. If this is not the case because of the late time of discovery or metastasis, there is a risk of blindness and death. In the follow-up care, one can only try to make the remaining days of life as pain-free and suffering as possible.
However, if the triggering tumor can be successfully irradiated, treated with chemotherapy and then operated on, follow-up care for Foster-Kennedy syndrome is different. In the aftercare phase, it must be ensured that the compressed optic nerve can recover and the intracranial pressure is reduced. In addition, the operation of the extensive tumor can leave serious after-effects. The extent to which these can be repaired depends on the individual case.
The problem is that the triggering tumor is often only discovered at a later stage because of the insidious onset of symptoms. The symptoms of Foster-Kennedy syndrome initially seem to indicate other medical conditions. These are often not considered dangerous. This usually delays the first visit to the doctor.
Once the tumor has been identified as the cause of Foster-Kennedy syndrome, treatment is often successful. However, metastases may already have formed. The damage to the optic nerve and the brain can be irreparable. In this case, the follow-up successes may not be as resounding as with an early discovery.
You can do that yourself
As a rule, the possibilities for self-help with Foster-Kennedy syndrome are relatively limited. The success of the treatment and the further course of the disease depend heavily on the severity of the tumor. The earlier this is recognized, the higher the probability of a positive course of the disease.
In many cases, those affected are dependent on psychological treatment. Conversations with closest friends or relatives can have a very positive effect on the course of the disease. Talking to other sufferers or other cancer sufferers can also alleviate psychological complaints.
Since the Foster-Kennedy syndrome also leads to permanent fatigue and exhaustion in the patient, he should be supported in his everyday life by family and friends. The person concerned should take great care of the body and not engage in strenuous activities. The family should also check that they are taking medication regularly.
Since the relatives of the patient often suffer from psychological complaints or depression, psychological treatment is also advisable for these people. In this way, serious upsets can be avoided.