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神经囊虫病导致福斯特-肯尼迪综合征不典型表现:罕见病例报告。

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

机构信息

Department of Ophthalmology, Moti Lal Nehru Medical College, Prayagraj, Uttar Pradesh, India.

出版信息

Rom J Ophthalmol. 2024 Apr-Jun;68(2):177-181. doi: 10.22336/rjo.2024.33.

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. 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.

摘要

本病例强调了与神经囊虫病(NCC)相关的福斯特-肯尼迪综合征(FKS)的非典型表现,NCC 是寄生虫流行地区占位性病变的常见原因。我们报告了一例新诊断的 NCC 病例,该病例发生于一名 13 岁男孩,他出现了一天的左侧身体异常运动,没有眼部主诉。患者眼底检查显示右眼颞侧视盘苍白,杯盘比(CDR)为 0.6,提示单侧视盘萎缩,左眼视盘充血,CDR 为 0.3,血管迂曲,提示对侧即将发生视盘水肿,类似于经典的 FKS 三联征。根据临床特征和影像学发现,他被诊断为 NCC,并开始使用卡马西平(400 mg)、泼尼松(60 mg)、阿苯达唑(400 mg)、乙酰唑胺(750 mg)和维生素 B12 复合物进行治疗。BCVA = 最佳矫正视力,CDR = 杯盘比,CT = 计算机断层扫描,FKS = 福斯特-肯尼迪综合征,IDSA = 传染病学会,ICP = 颅内压,IOP = 眼内压,MRI = 磁共振成像,NCC = 神经囊虫病,OOC = 眼眶/眼囊虫病,OD = 右眼,OS = 左眼,OU = 双眼,RNFL = 视网膜神经纤维层,WNL = 正常范围内。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94f5/11238855/db075f185115/RomJOphthalmol-68-177-g001.jpg

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