Balint syndrome

Q: What is Balint syndrome?

Answer: Balint syndrome, initially described as psychic paralysis of visual fixation (a misnomer) 70 years ago, is a triad of 

• simultanagnosia 
• optic ataxia
• ocular apraxia 

Simultanagnosia means the inability to integrate a visual scene despite adequate acuity to resolve individual elements.

Optic ataxia is the inability to reach accurately under visual guidance. It is caused by a visual-motor coordination issue. 

Ocular apraxia is the inability to direct gaze accurately to a new target, frequently leading to difficulty reading. This is due to problems with voluntary eye movements, including difficulty shifting gaze to different objects or maintaining fixation.

Balint syndrome is often associated with neurological diseases in the parietal and occipital lobes. It signifies bilateral lesions, such as in watershed infarction or reversible cerebral vasoconstriction syndrome (RCVS). It can also be idiopathic.

#neurology

References:

1. Walsh RD, Floyd JP, Eidelman BH, Barrett KM. Bálint syndrome and visual allochiria in a patient with reversible cerebral vasoconstriction syndrome. J Neuroophthalmol 2012; 32:302.

2. Pisella L, Vialatte A, Khan AZ, Rossetti Y. Bálint syndrome. Handb Clin Neurol. 2021;178:233-255. doi: 10.1016/B978-0-12-821377-3.00011-8. PMID: 33832679.

3. HECAEN H, DE AJURIAGUERRA J. Balint's syndrome (psychic paralysis of visual fixation) and its minor forms. Brain. 1954;77(3):373-400. doi: 10.1093/brain/77.3.373. PMID: 13208876.

4. Ghoneim A, Pollard C, Greene J, Jampana R. Balint syndrome (chronic visual-spatial disorder) presenting without known cause. Radiol Case Rep. 2018 Sep 20;13(6):1242-1245. doi: 10.1016/j.radcr.2018.08.026. PMID: 30258515; PMCID: PMC6148828.