What Is Balint's Syndrome?

A rare condition makes it difficult to recognize your surroundings

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Imagine this: When you get out of bed in the morning, you can’t distinguish where the drawers are that hold your clothes. At first you think you might just be tired, but then you realize you can’t figure out where the wall ends, and where the door begins. You want to telephone for help, but struggle to find your cell phone. Fortunately, your family member points out that the phone is in fact right in front of you, on the counter where you left it.

When the phone is handed to you, the numbers seem to float in space, making it impossible for you to dial a number.

Could there be something wrong with your eyes? You go to the eye doctor and are told that your vision is perfect, despite the fact that you can hardly find the door to leave the office. The ophthalmologist gives you a referral to a neurologist. What’s going on?

What Is Balint's syndrome?

Balint’s syndrome is a rare neurological condition which causes:

  • Oculomotor apraxia: the inability to intentionally move your eyes towards an object
  • Optic ataxia: the inability to accurately reach for something you're looking at
  • Visual simultagnosia: an inability to see the whole picture. Instead, if you have Balint's syndrome, you only see parts of the whole. For example, when shown a picture of a house, you would only see a window, a door, a wall, and so on, but not the entire house.

If you have Balint’s syndrome, you'll need to depend on your other senses to guide you.

You may, for example, need to keep a hand on the sink in order to know where it is in the bathroom. And you may need to put toothpaste in your mouth, rather than on the toothbrush. You may not be able to use utensils at the table since you can’t use your vision to aim your hand to pick up a fork or a spoon.

In addition, it may be impossible to read, since simultagnosia means you may only see one letter at a time, and may not be able to put that letter into the context of a word or sentence.

What Causes Balint's Syndrome?

Balint's syndrome usually results from damage to both parietal lobes, the part of your brain which lets you know where you are as well as other objects. When symptoms come on suddenly, they're likely due to stroke. However, other disorders such as tumors, trauma, near-drowning, eclampsia, HIV encephalitis, and even neurodegenerative diseases such as Alzheimer’s, can also lead to Balint’s syndrome.

Because Balint’s syndrome is relatively uncommon, the symptoms are often missed. Knowing that visual disturbances may not always be a problem with your eyes, but can also result from trouble with the brain, is a good start. If you are concerned about your vision or spatial disturbances or that of a loved one, please seek the guidance of a neurologist. 

Therapy for People With Balint's syndrome

Occupational therapy, in some cases, can help you recover some independence. While different approaches have been suggested, no one approach is clearly the best, and it may be helpful to consider using techniques designed to assist those who are blind.

For example, your therapist may suggest ways to use your other senses to replace damaged perception. Books on tape can be used instead of usual reading material, and a radio may replace television viewing. 

Sources

Amalnath SD, Kumar S, Deepanjali S, & Dutta TK. Balin syndrome. Ann Indian Acad Neurol. 2014 Jan-Mar;17(1):10-11.

Jason Cuomo, Murray Flaster, and Jose Biller. Living with Balint's: A Descriptive, Narrative Account of Two Patients' Adaptations to Living with a Rare and Disabling Visuoperceptual Disorder (P02.036)​ Neurology. 2012.

Allan Ropper and Robert Brown, Adam's and Victor's Principles of Neurology, 8th Edition McGraw-Hill Companies Inc, United States of America, 2005, pp 417-430.

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