Balint's syndrome: Her vision is 20/20, but she can't make sense of what she sees

September 10, 2012

It was a quiet Thursday afternoon when AS, a 68-year-old woman from a suburb of Chicago, awakened from a nap to the realization that something was terribly wrong.

Thus begins a Loyola University Medical Center paper on a rare and baffling called Balint's syndrome, which badly impairs a patient's ability to make sense of what he or she sees.

The article describes, in novelistic detail, the difficult adjustments two patients have had to make in their lives. The article is published in the Sept. 11, 2012, issue of Neurology, the medical journal of the American Academy of Neurology. The paper was written by Jose Biller, MD, Murray Flaster, MD, and first author Jason Cuomo. Biller and Flaster are and Cuomo is a fourth-year medical student at Loyola University Chicago Stritch School of Medicine.

The authors note that amid the rigors of clinical practice, physicians can content themselves with understanding the phenomenon of disease to the exclusion of understanding the patient's experience. Their article "is an attempt to inform both our clinical and subjective understandings of Balint's syndrome through narratives of two patients suffering from this rare and unique neurological disorder."

Balint's syndrome is named after Austro-Hungarian neurologist Rezső Bálint, who first described it. The condition is caused by one or more strokes in certain regions of the brain. It causes three deficits: Difficulty initiating voluntary (such as following a physician's finger); inaccurate arm pointing (a patient can see an object, but is unable to pick it up); and constriction of the visual field (ask a patient to look at a parking lot, and all she sees is a lamp post or a car.)

When AS woke from her nap, she couldn't find where doors or cabinets were. She couldn't name or distinguish familiar household objects. She couldn't read a book or the numbers on her telephone. She couldn't see where the bedroom wall ended and the door began.

Yet when she saw an ophthalmologist, her vision with glasses was 20/20. She and her husband left the ophthalmologist's office with a referral to see a neurologist, and "wondering what sort of ailment could rob her of her ability to see the bathroom sink, while leaving her with what we typically think of as perfect vision."

The second patient, JD, was a robust, hard-working owner of a trucking business. While driving to his son's house for Thanksgiving, he began to swerve. And at Thanksgiving dinner, he held the spoon upside down. He then experienced left-sided weakness and facial drooping, before losing consciousness. Doctors believe he had suffered a massive stroke, followed by a series of mini strokes.

AD has made many adjustments. For example, while getting ready in the morning, she must touch the sink at all times to remain oriented. While showering, she has to keep her hand on the shower bar. Before brushing her teeth, she puts the toothpaste directly in her mouth, then moves the toothbrush by trial and error to meet it. She has stopped driving. And because she can no longer read, she listens to audio books.

JD has suffered depression, a first for him. "He never once cried before," his wife said, "but now he cries often."

AD said she would not wish Balint's syndrome on anyone, "because not only is this a life-change, it's a mind change."

AD hopes her story will motivate physicians to seek better treatments and therapies.

Explore further: Cholesterol-lowering statin drugs can reduce the risk of stroke, but sometimes should be avoided

Related Stories

Cholesterol-lowering statin drugs can reduce the risk of stroke, but sometimes should be avoided

August 19, 2011
For many patients, cholesterol-lowering statin drugs can reduce the risk of strokes as well as heart attacks. But in a review article, Loyola University Health System neurologists caution that statins may not be appropriate ...

Study finds paramedics skilled in identifying strokes

March 28, 2012
(Medical Xpress) -- If a paramedic suspects a patient is having a stroke, the paramedic is probably right, a Loyola University Medical Center study has found.

Easy-to-use blood thinners likely to replace Coumadin

February 6, 2012
Within a few years, a new generation of easy-to-use blood-thinning drugs will likely replace Coumadin for patients with irregular heartbeats who are at risk for stroke, according to a journal article by Loyola University ...

Recommended for you

Mechanism explains how seizures may lead to memory loss

October 16, 2017
Although it's been clear that seizures are linked to memory loss and other cognitive deficits in patients with Alzheimer's disease, how this happens has been puzzling. In a study published in the journal Nature Medicine, ...

Study shows people find well-being more so from special places than from mementoes

October 16, 2017
(Medical Xpress)—A team of researchers at the University of Surrey has found that people experience a feeling of well-being when thinking about or visiting a place that holds special meaning to them. They also found that ...

fMRI scans reveal why pain tolerance goes up during female orgasm and shows brain does not turn off

October 13, 2017
(Medical Xpress)—A team of researchers at Rutgers University has determined why women are able to tolerate more pain during the time leading up to and during orgasm. In their paper published in the Journal of Sexual Medicine, ...

Neuroscientists identify genetic changes in microglia in a mouse model of neurodegeneration and Alzheimer's disease

October 13, 2017
Microglia, immune cells that act as the central nervous system's damage sensors, have recently been implicated in Alzheimer's disease.

Restless legs syndrome study identifies 13 new genetic risk variants

October 13, 2017
A new study into the genetics underlying restless legs syndrome has identified 13 previously-unknown genetic risk variants, while helping inform potential new treatment options for the condition.

Blueberries may improve attention in children following double-blind trial

October 13, 2017
Primary school children could show better attention by consuming flavonoid-rich blueberries, following a study conducted by the University of Reading.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.