Balint's Syndrome - MedFriendly.com

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.

FEATURED BOOK: Adams and Victor's Principles of Neurology

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 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.