Bálint’s syndrome is a complex and not yet fully understood neurological disorder in which patients are, as it were, “seeing blind”. A brain injury is usually the cause of this. The primary symptoms are simultaneous agnosia (the inability to perceive simultaneous events or objects in the visual field), oculomotor apraxia (difficulty fixating the eyes), optic ataxia (inability to see and grasp an object) resulting in visual-spatial disorientation. The rare syndrome was first described in 1909 by the Hungarian physician Rezső Bálint.
- Epidemiology Bálint syndrome
- Causes of neurological disorder
- Symptoms: Being visually blind
- Diagnosis and examinations
- Therapy
- Prognosis condition
Epidemiology Bálint syndrome
No exact figures are known in the scientific literature about the prevalence of Bálint’s syndrome.
Causes of neurological disorder
Bálint’s syndrome usually develops acutely (medical term for “sudden”) as a result of two or more lesions in approximately the same location at the back of the brain lobes (bilateral posterior parietal lesion). Patients may therefore develop sudden and severe hypotension (low blood pressure). Multiple strokes, Alzheimer’s disease (form of dementia ultimately leading to severe memory loss), intracranial tumors and Creutzfeldt-Jakob disease (progressive brain disease) cause this brain damage. Despite the fact that it has been a hundred years since Rezső Bálint first reported the complex and severe visuospatial problems in his patient, scientists are still working on the analysis and conclusions of the syndrome.
Symptoms: Being visually blind
The most prominent and most studied symptom associated with Bálint syndrome is simultaneous agnosia . Simultaneous agnosia is the inability to interpret complex visual images due to problems processing multiple objects and their relationships.
Oculomotor apraxia also occurs . Bálint described this as a psychological paralysis of the gaze. Fixating on objects is difficult.
Finally, patients suffer from optic ataxia , which causes them to be unable to see and then grasp an object. An error in the dorsal pathway of the brain is the cause of this.
In practice, patients often behave blindly because they lack normal visual awareness of the outside world. For the patient, the outside world is all chaos with a collection of statistical objects.
Diagnosis and examinations
Because this syndrome almost never occurs and is relatively unknown to doctors, it is very difficult for the doctor to diagnose it. Sometimes this leads to a misdiagnosis such as blindness, psychosis (loss of reality with delusions and hallucinations) or dementia. This then results in inappropriate or insufficient treatment. A severe image disturbance in which spontaneous and acute bilateral parietal damage occurs strongly suggests the presence of Bálint’s syndrome.
Therapy
Each patient has unique cognitive and neurological conditions that require an individual approach . There are no known effective treatment options. However, a patient can benefit from a number of techniques.
First of all, the patient must receive a good explanation about his condition so that he understands and recognizes the problems. This is already a first basis for learning to deal with his reduced vision.
The patient is then given tips for improving vision . A patient learns to focus on one thing at a time. Because he is unable to look at the sides of his visual field, he quickly learns to scan and recognize visual patterns with the help of head movements. By using a red line in texts, he may concentrate better on the text area on the page to be read.
Exercises related to eye-hand coordination are possible to improve optic ataxia . The approach is careful and safe, especially in the beginning. First, the patient practices catching a wad of paper, for example. Then the patient must catch a safe ball. The patient then continues to practice this until he can even grasp a tennis ball. An advanced exercise is bouncing the ball against a wall.
Prognosis condition
Progressive simultaneous agnosia occurs together with other functional disorders due to posterior parietal and temporal defects, such as alexia (inability to read due to a central lesion), acalculia (inability to calculate), right-left disorientation and mild memory and language disorders. Bálint’s syndrome often manifests itself in very different ways, making it difficult to give a prognosis.
The condition does have a major impact on daily life. Simple and previously easy tasks such as walking or eating and drinking become very difficult because the patient perceives only one object at a time, does not make connections and does not grasp objects.
