ICD-10: H47.142

Foster-Kennedy syndrome is a rare neurological condition characterized by a specific set of clinical features primarily affecting the optic nerve and visual pathways. The ICD-10 code H47.142 specifically refers to Foster-Kennedy syndrome affecting the left eye. Below is a detailed overview of the syndrome, its clinical description, and relevant diagnostic information.

Clinical Description of Foster-Kennedy Syndrome

Definition and Etiology

Foster-Kennedy syndrome is typically associated with a mass lesion in the anterior cranial fossa, often due to a tumor such as a meningioma. This condition leads to a combination of symptoms resulting from increased intracranial pressure and direct effects on the optic nerve. The syndrome is named after the physicians who first described it, highlighting its distinctive clinical presentation.

Key Clinical Features

The hallmark features of Foster-Kennedy syndrome include:

• Unilateral Visual Loss: Patients often experience significant vision impairment in the affected eye, which in this case is the left eye (H47.142).
• Optic Atrophy: There is typically evidence of optic nerve atrophy on examination, which can be observed through fundoscopic evaluation.
• Papilledema: Swelling of the optic disc may occur due to increased intracranial pressure, although it may not always be present.
• Contralateral Abnormalities: Patients may also exhibit signs of contralateral (opposite side) cranial nerve involvement, such as anosmia (loss of smell) or other neurological deficits.

Diagnosis

Diagnosis of Foster-Kennedy syndrome involves a combination of clinical evaluation and imaging studies. Key steps include:

1. Clinical Examination: A thorough neurological examination is essential to assess visual acuity, visual fields, and the presence of optic nerve abnormalities.
2. Imaging Studies: MRI or CT scans of the brain are crucial for identifying any mass lesions in the anterior cranial fossa that may be causing the symptoms. These imaging modalities help visualize the extent of the lesion and its effect on surrounding structures.

Differential Diagnosis

It is important to differentiate Foster-Kennedy syndrome from other conditions that may present with similar symptoms, such as:

• Other types of optic neuropathy
• Intracranial hypertension without a mass
• Other cranial nerve palsies

Coding and Documentation

The ICD-10-CM code H47.142 is specifically designated for cases of Foster-Kennedy syndrome affecting the left eye. Accurate coding is essential for proper documentation, billing, and treatment planning. The code falls under the broader category of disorders of the optic nerve and visual pathways, which includes various other conditions affecting vision.

Related Codes

• H47.14: This code encompasses Foster-Kennedy syndrome in general, without specifying the affected eye.
• H47.11-13: These codes relate to other forms of papilledema and optic nerve disorders.

Conclusion

Foster-Kennedy syndrome is a complex condition that requires careful clinical assessment and imaging for accurate diagnosis and management. The specific ICD-10 code H47.142 allows healthcare providers to document cases involving the left eye, facilitating appropriate treatment and follow-up. Understanding the clinical features and implications of this syndrome is crucial for effective patient care and management.

Foster-Kennedy syndrome is a rare neurological condition characterized by a specific set of clinical presentations, signs, symptoms, and patient characteristics. This syndrome is associated with a unilateral optic atrophy and contralateral papilledema, typically resulting from a mass lesion in the frontal lobe, such as a meningioma. Below is a detailed overview of the clinical aspects related to ICD-10 code H47.142, which specifically pertains to Foster-Kennedy syndrome affecting the left eye.

Clinical Presentation

Overview

Foster-Kennedy syndrome manifests primarily due to increased intracranial pressure and optic nerve compression. The condition is often linked to a frontal lobe tumor, which can lead to a combination of visual disturbances and neurological deficits.

Signs and Symptoms

1. Unilateral Optic Atrophy:
   - The hallmark of Foster-Kennedy syndrome is the atrophy of the optic nerve on the side of the lesion. In the case of H47.142, this would be the left eye. Patients may experience a gradual loss of vision in the affected eye, which can be detected through visual acuity tests and fundoscopic examination.

2. Contralateral Papilledema:
   - Patients typically exhibit swelling of the optic disc in the eye opposite to the side of the lesion (right eye in this case). This occurs due to increased intracranial pressure and can be observed during an eye examination.

3. Visual Field Defects:
   - Patients may report visual field deficits, particularly in the peripheral vision of the affected eye. This can include scotomas or a general reduction in visual field sensitivity.

4. Neurological Symptoms:
   - Depending on the size and location of the frontal lobe mass, patients may also present with other neurological symptoms such as headaches, personality changes, cognitive impairments, or seizures.

5. Other Ocular Symptoms:
   - Diplopia (double vision) or other ocular motility issues may occur, particularly if the mass affects cranial nerves responsible for eye movement.

Patient Characteristics

• Demographics: Foster-Kennedy syndrome can occur in adults, with a higher prevalence in middle-aged individuals. There is no significant gender predisposition noted.
• Medical History: Patients may have a history of headaches or other neurological symptoms prior to the onset of visual changes. A thorough medical history is essential to identify any previous head trauma or neurological conditions.
• Diagnostic Imaging: MRI or CT scans of the head are crucial for diagnosing the underlying mass lesion. These imaging modalities can reveal the presence of a frontal lobe tumor, which is often responsible for the syndrome.

Conclusion

Foster-Kennedy syndrome, particularly as classified under ICD-10 code H47.142 for the left eye, presents a unique combination of unilateral optic atrophy and contralateral papilledema, primarily due to a mass effect in the frontal lobe. Early recognition of the signs and symptoms, along with appropriate imaging studies, is essential for effective management and treatment of the underlying cause. If you suspect a patient may have this syndrome, a comprehensive neurological evaluation and timely referral to a specialist are recommended for optimal outcomes.

Foster-Kennedy syndrome, classified under ICD-10 code H47.142, is a rare neurological condition characterized by specific ocular and neurological symptoms. Understanding alternative names and related terms can enhance clarity in medical documentation and communication. Below are some alternative names and related terms associated with this syndrome.

Alternative Names for Foster-Kennedy Syndrome

1. Foster-Kennedy Syndrome: This is the primary name used in medical literature and coding.
2. Foster-Kennedy Syndrome, Left Eye: Specifically refers to the manifestation affecting the left eye, as denoted by the ICD-10 code H47.142.
3. Optic Nerve Atrophy: This term may be used in conjunction with Foster-Kennedy syndrome, as the condition often involves atrophy of the optic nerve.
4. Papilledema: While not synonymous, papilledema (swelling of the optic disc) is a common feature in patients with Foster-Kennedy syndrome and is classified under related ICD codes (H47.11-13) for papilledema.

Related Terms

1. Intracranial Hypertension: This condition can lead to symptoms seen in Foster-Kennedy syndrome, including optic nerve swelling.
2. Optic Nerve Disorders: A broader category that includes various conditions affecting the optic nerve, of which Foster-Kennedy syndrome is a specific example.
3. Neurological Disorders: Since Foster-Kennedy syndrome has neurological implications, it falls under this broader category.
4. Visual Field Defects: Patients may experience specific visual field losses, which are relevant when discussing the syndrome's impact on vision.

Clinical Context

Foster-Kennedy syndrome is often associated with a mass effect in the cranial cavity, such as a tumor, which can lead to the characteristic symptoms of unilateral optic atrophy and contralateral papilledema. Understanding these terms is crucial for accurate diagnosis, treatment planning, and coding in medical records.

In summary, while "Foster-Kennedy syndrome" remains the primary term, related terms and alternative names provide a comprehensive understanding of the condition and its implications in clinical practice.

Foster-Kennedy syndrome is a rare neurological condition characterized by a specific set of clinical features, primarily involving the optic nerve and its associated structures. The diagnosis of Foster-Kennedy syndrome, particularly for the left eye as indicated by the ICD-10 code H47.142, involves a combination of clinical evaluation, imaging studies, and specific criteria. Below is a detailed overview of the criteria used for diagnosis.

Clinical Features

1. Optic Atrophy: One of the hallmark signs of Foster-Kennedy syndrome is optic atrophy in the affected eye. In this case, the left eye would show signs of optic nerve damage, which can be assessed through a comprehensive eye examination.

2. Papilledema: The presence of papilledema (swelling of the optic disc) in the contralateral (right) eye is another critical feature. This occurs due to increased intracranial pressure, which is often associated with the underlying causes of the syndrome.

3. Visual Field Defects: Patients may exhibit specific visual field defects, particularly in the affected eye. These defects can be evaluated using visual field testing, which helps in assessing the extent of vision loss.

4. Neurological Symptoms: Additional neurological symptoms may be present, including headaches, nausea, or other signs of increased intracranial pressure. A thorough neurological examination is essential to identify these symptoms.

Diagnostic Imaging

1. Magnetic Resonance Imaging (MRI): MRI of the brain is crucial for identifying any mass lesions, such as tumors, that may be causing the symptoms associated with Foster-Kennedy syndrome. The imaging can reveal the presence of a mass effect on the optic nerve or other structures.

2. Optical Coherence Tomography (OCT): This non-invasive imaging technique can be used to assess the retinal nerve fiber layer and provide additional information about optic nerve health.

Differential Diagnosis

It is essential to differentiate Foster-Kennedy syndrome from other conditions that may present with similar symptoms, such as:

• Intracranial tumors: These can cause similar optic nerve changes and increased intracranial pressure.
• Other forms of optic neuropathy: Conditions like ischemic optic neuropathy or hereditary optic neuropathies should be considered.

Conclusion

The diagnosis of Foster-Kennedy syndrome, particularly for the left eye (ICD-10 code H47.142), relies on a combination of clinical findings, imaging studies, and the exclusion of other potential causes of the symptoms. A multidisciplinary approach involving ophthalmologists and neurologists is often necessary to ensure accurate diagnosis and appropriate management. If you have further questions or need more specific information, feel free to ask!

Foster-Kennedy syndrome is a rare neurological condition characterized by a combination of symptoms, including optic atrophy in one eye and papilledema in the other, often due to a mass effect from a tumor, typically in the frontal lobe. The ICD-10 code H47.142 specifically refers to Foster-Kennedy syndrome affecting the left eye. Understanding the standard treatment approaches for this condition involves a multidisciplinary approach, focusing on the underlying cause, symptom management, and rehabilitation.

Diagnosis and Initial Assessment

Before treatment can begin, a thorough diagnostic process is essential. This typically includes:

• Clinical Evaluation: A detailed history and neurological examination to assess visual function and neurological status.
• Imaging Studies: MRI or CT scans are crucial for identifying any intracranial masses, such as tumors, that may be causing the syndrome. These imaging techniques help in determining the size, location, and nature of the lesion[1].

Treatment Approaches

1. Addressing the Underlying Cause

The primary treatment for Foster-Kennedy syndrome focuses on the underlying cause, which is often a tumor. Treatment options may include:

• Surgical Intervention: If a tumor is identified, surgical resection may be necessary. This is particularly relevant for accessible tumors that can be safely removed, which may alleviate the pressure on the optic nerve and reduce symptoms[2].
• Radiation Therapy: For tumors that are inoperable or for patients who are not surgical candidates, radiation therapy may be employed to shrink the tumor and relieve pressure on the optic nerve[3].
• Chemotherapy: In cases where the tumor is malignant, chemotherapy may be indicated as part of a comprehensive treatment plan[4].

2. Symptom Management

In addition to treating the underlying cause, managing symptoms is crucial for improving the quality of life:

• Optic Nerve Protection: Corticosteroids may be prescribed to reduce inflammation and swelling around the optic nerve, potentially preserving vision[5].
• Pain Management: Analgesics or other pain management strategies may be necessary if the patient experiences headaches or other discomfort related to increased intracranial pressure[6].

3. Rehabilitation and Supportive Care

Rehabilitation plays a vital role in the management of Foster-Kennedy syndrome:

• Visual Rehabilitation: Patients may benefit from visual rehabilitation services to help adapt to changes in vision. This can include occupational therapy and the use of visual aids[7].
• Psychological Support: Given the potential impact on mental health due to vision loss and neurological symptoms, psychological support or counseling may be beneficial[8].

Conclusion

Foster-Kennedy syndrome, particularly when affecting the left eye as indicated by ICD-10 code H47.142, requires a comprehensive treatment approach that addresses both the underlying cause and the associated symptoms. Early diagnosis and intervention are critical for optimizing outcomes. A multidisciplinary team, including neurologists, ophthalmologists, oncologists, and rehabilitation specialists, is essential for providing effective care tailored to the individual needs of the patient. Regular follow-up and monitoring are also important to assess treatment efficacy and make necessary adjustments.

References

1. Clinical evaluation and imaging studies for diagnosis.
2. Surgical intervention for tumor resection.
3. Radiation therapy for inoperable tumors.
4. Chemotherapy for malignant tumors.
5. Use of corticosteroids for optic nerve protection.
6. Pain management strategies.
7. Visual rehabilitation services.
8. Psychological support for mental health.