Atypical Presentation of Foster Kennedy Syndrome due to Neurocysticercosis: A Rare Case Report

TL;DR

A 13-year-old boy with Neurocysticercosis showed atypical Foster Kennedy Syndrome symptoms, including abnormal body movements and optic disc changes.

Contribution

This case report presents a rare and atypical clinical manifestation of Foster Kennedy Syndrome caused by Neurocysticercosis.

Findings

The patient exhibited unilateral optic disc atrophy and contralateral disc edema without typical ocular complaints.

Neurocysticercosis was diagnosed using clinical and radiological findings in a pediatric patient.

Treatment included a combination of anticonvulsants, corticosteroids, antiparasitic drugs, and supplements.

Abstract

This case highlights the atypical presentation of Foster-Kennedy syndrome (FKS) associated with Neurocysticercosis (NCC), a prevalent cause of space-occupying lesions in areas endemic to the parasite. We report a newly diagnosed case of NCC in a 13-year-old boy who presented with a one-day history of abnormal movements of the left side of the body and no ocular complaints. Fundus examination of the patient revealed temporal disc pallor and a cup disc ratio (CDR) of 0.6 in the right eye suggesting unilateral optic disc atrophy and a hyperaemic disc with CDR 0.3 and blood vessel tortuosity in the left eye suggesting contralateral impending disc edema, mimicking the classic triad of FKS. He was diagnosed with NCC based on clinical features and radiological findings and was started on Carbamazepine (400 mg), Prednisolone (60 mg), Albendazole (400 mg), Acetazolamide (750 mg), and Vitamin B12 complex.

Abbreviations: BCVA = Best Corrected Visual Acuity, CDR = Cup-Disc Ratio, CT = Computed Tomography, FKS = Foster Kennedy Syndrome, IDSA = Infectious Diseases Society of America, ICP = Intracranial Pressure, IOP = Intraocular Pressure, MRI = Magnetic Resonance Imaging, NCC = Neurocysticercosis, OOC = Orbital/Ocular Cysticercosis, OD = Right Eye, OS = Left Eye, OU = Both Eyes, RNFL = Retinal Nerve Fibre Layer, WNL = Within Normal Limits

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