Atypical Foster Kennedy Syndrome With Orbital Apex Involvement Secondary to Intracranial Meningiomatosis: A Case Report.
Hatim Bazhar, Loubna Moulahid, Zakaria Azemour et al.
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Case in brief
A 43-year-old man presented with left conjunctival chemosis, which was the initial sign of an atypical Foster Kennedy syndrome. His examination revealed bilateral proptosis, left complete ophthalmoplegia, and optic atrophy, alongside neuroimaging that showed intracranial meningiomatosis. The chemosis was linked to meningioma extension into the cavernous sinus and orbital apex. Conservative treatment with corticosteroids and acetazolamide led to a favorable clinical outcome.
What made this case unusual
The case highlights an atypical presentation of Foster Kennedy syndrome with orbital apex involvement, which is not commonly reported and suggests a complex pathophysiological mechanism.
Diagnostic / clinical pearl
Clinicians should consider atypical presentations of Foster Kennedy syndrome, especially when initial symptoms include conjunctival chemosis and proptosis, as these may indicate underlying meningiomatosis.
Why it matters
Understanding the diverse presentations of Foster Kennedy syndrome can aid in timely diagnosis and management, particularly in cases with complex intracranial involvement.