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Balint's syndrome is a condition characterized by optic ataxia (inability to move the hand to an object by using vision), ocular apraxia (inability to voluntarily control the gaze), and simultanagnosia (inability to recognize more than one object shown at the same time).
WHAT ARE OTHER CHARACTERISTIC OF BALINT'S SYNDROME?
In Balint's syndrome, the individual cannot look into the sides of their visual field. The visual field is the space that someone can see without moving the eyes. The patient usually has greater difficulty seeing things in the right side of their visual fields. They have great difficulty putting visual pieces of information together. As a result, they may only be able to focus on individual details of what they see. For example, when shown a picture of a forest, they may only see a tree and won't realize that what they are looking at is a forest. So these people often literally miss the forest for the trees. This visual problem is what leads people with Balint's syndrome to have difficulty seeing more than one object at a time. People with Balint's syndrome also have difficulty estimating distances in visual space and coordinating actions depending on the particular spatial arrangement.
WHAT PARTS OF THE BRAIN ARE AFFECTED IN BALINT'S SYNDROME?
The visual difficulties in Balint's syndrome are usually due to damage to the top part of the temporal-occipital lobes on both sides of the brain. The temporal lobe is on the side of the brain by the ear and the occipital lobe is the back part of the brain. So the temporal-occipital lobes refer to the sides and back parts of the brain. In Balint's syndrome, the top part of the parietal lobes on both sides of the brain may also be affected. The parietal lobes are the middle area of the top part of the brain.
WHAT CAN BE DONE TO TREAT BALINT'S SYNDROME?
There are several structured techniques that can be used to treat Balint's syndrome that provide the patient with immediate feedback. For each of these techniques, the degree of structure decreases as the task becomes more familiar. The structure decreases to levels that are more likely to be encountered in the patient's environment. But before any of these techniques can be used, the patient needs to admit that the problems exists and believe that they can learn to trust their vision.
One technique involves helping the patient focus on more than one thing at a time and to improve the ability to tell things apart with vision. In this technique, flash cards are shown to the patient with two lines on them. The patient is asked if the two lines look the same or different. The answer is written on the back of the flash card. If the angles are different, the degree of difference is noted on the back of the card as well. By using this technique, the patient can get immediate feedback as to whether he/she perceives things accurately. Also, a family member can use the flash cards with the patient or the patient can use them by him or herself.
Different types of flashcards can also be used to help the patient focus on the general aspect of something instead of only focusing on the details. The flashcards have a clock face on the front with all 12 numbers. Once the patient is used to this, the clocks only have the numbers 12, 3, 6, and 9 on them. Finally, the numbers are faded out and the patient is asked to tell what time it is based only on the hands of the clock. This requires focusing on the details to answer a general question based on visual information. The time is written in digital form on the back of the cards so the patient can get immediate feedback.
Some patient's with Balint's syndrome only respond to part of what they see when the object(s) is close up. Thus, one strategy is to determine how far the patient can see and to place the object(s) farther away in the field of vision. In some cases, this helps the patient improve the ability to see the entire object and not just a part of it.
Since people with Balint's syndrome cannot look into the sides of their visual field, techniques can be used to improve the person's ability to scan visual patterns quickly. The visual field is the space that someone can see without moving the eyes. Some techniques to improve visual ability include having the patient make wide head turns towards the areas that he/she cannot see when looking straight ahead. Such wide head turns help the patient gather more information about the environment.
Reading material that is in the area that the person has difficulty seeing can be marked with an up and down red line. By doing this, the patient will see the red line and be more aware of their difficulty attending to that area of the page. This, in turn, can allow the patient to be sure to focus more attention on that particular area of the page.
To improve optic ataxia (inability to move the hand to an object by using vision) exercises can be done that require eye hand coordination and manipulating objects with the hands. Using tools would be an example as would be catching a ball. Obviously, safe tools should be used and it is often helpful to start the ball-catching exercise with a ball made of crunched up paper. The patient can then progress to balls that travel faster when thrown such as tennis balls. This task can be made more difficult by bouncing the ball against a wall first.
WHAT ELSE IS BALINT'S SYNDROME KNOWN AS?
Balint's syndrome is also known as Balint's-Holmes syndrome.
WHAT IS THE ORIGIN OF THE TERM, BALINT'S SYNDROME KNOWN AS?
Balint's syndrome was named after Rezso (Rudolph) Balint, a neurologist and psychiatrist from Hungary. A neurologist is a medical doctor that specializes in the diagnosis and treatment of diseases of the nervous system. A psychiatrist is a medical doctor that specializes in psychiatry, a medical specialty that deals with the causes, diagnosis, and treatment of disorders of the mind, emotions, and behavior. Balint lived from 1874-1929. The term "Balint's-Holmes syndrome", which means the same thing as Balint's syndrome, recognizes the work of Irish neurologist, George Morgan Holmes. He lived from 1876 to 1965.