[Pseudo-Foster Kennedy Syndrome secondary to idiopathic intracranial hypertension: a case report]

Pseudo-Foster Kennedy syndrome is a rare condition characterized by unilateral papilledema with contralateral optic atrophy in the absence of an intracranial mass causing direct compression of the optic nerve. We here report the case of a 75-year-old overweight female patient (BMI 30 kg/m²), with poorly controlled hypertension, who presented with decreased visual acuity. The patient reported headaches evolving over 2 months. Ophthalmologic examination showed papilledema in the right eye and optic nerve atrophy in the left eye. Physical examination revealed poorly controlled arterial hypertension with a peak blood pressure of 200/110 mmHg. The patient underwent neurological examination and brain imaging, both of which revealed no abnormalities. A lumbar puncture was performed and revealed increased resistance to CSF flow (34 cmH2O). Other tests were normal. The diagnosis of pseudo-Foster Kennedy syndrome secondary to idiopathic intracranial hypertension (IIH) was established. The patient was treated with oral acetazolamide. The evolution was marked by complete resolution of papilledema and headaches, with gradual recovery of visual acuity in the right eye. Idiopathic intracranial hypertension is a rare cause of pseudo-Foster Kennedy syndrome. Only a few cases have been reported in the literature. It should be considered when this syndrome is present in order to preserve both visual and vital prognosis.