Bálint's syndrome

The Bálint 's syndrome is a rare neurological syndrome. It describes a severe spatial attention and orientation disorder and consists of

• Optical Ataxia: Inability purposive hand or gripping movements under control of the eyes.
• Ocular apraxia: inability targeted eye movements with his eyes.
• Simultanagnosie: Extreme narrowing of visual attention to individual aspects of complex images, so they can not be construed as a whole.

Symptoms

1 ) Disorders of spatial orientation 2 ) Optical ataxia 3) Simultanagnosie 4) Looking disorders. When Bálint 's syndrome, all features are present. However, each of the four symptoms can also occur on its own. One side of the syndrome describes a visual attention disorder. The affected people take the visual world mistakenly perceive as disjointed amount of individual objects. More complex images or scenes can therefore no longer be detected in the whole. This part of the syndrome is referred to by Wolpert as Simultanagnosie. Another attention deficit exists in the very often associated with Bálint syndrome hemineglect (non- observance of a half-space including the own body sites), as well as in the patient described by Bálint itself.

The other side of the syndrome describes a severe spatial disorientation. The visual information obtained by the eye and can not be used for coordination of eye movement (ocular apraxia ) and gripping movements ( ataxia optical ). The people concerned may therefore their views do not turn aside to a desired object in the visual field. Nor do they reach for things in the visual field, or control their hands with their eyes. Most, therefore, arises also the inability to read ( alexia ) and writing ( agraphia ). The condition affects the visual imagination. Finally, there is, as a result of the spatial orientation disorder, a decreased perception of depth in space, so that distances can not be estimated.

A case study from Scotland, published in 2003 described a Bálint 's syndrome in a 10 -year-old child who had suffered endocarditis in the third year, as a result there had been bleeding in the brain. The child was presented to pediatricians by the parents, as it had big problems in school. It could not properly read and write, because it confused words and letters. In addition to these interpreted as Simultanagnosie symptoms had occurred according to the authors and to all the other symptoms that belong to a Bálint 's syndrome.

Anatomical

The reason for the frame of Bálint syndrome are bilateral (both sides of the brain are affected) parietal or parieto- occipital brain damage. The lesion includes both sides of the case lying at the junction of parietal, temporal and occipital lobes gyri angular gyrus and supramarginal gyrus with a. Not affected is the visual cortex. However, it can also cause other brain lesions -like symptoms, such as diffuse damage in dementia or Creutzfeldt -Jakob disease, and functional disorders, such as psychosis. Also described are bilateral basal ganglia lesions with isolated fixation disorders, bilateral frontal lesions, and malignant brain tumors with growth above the bars on the opposite side of the brain. For the shift of attention between two objects in the visual field appears to the cortex of the left parietal lobe is responsible, whereas the attentional shift is taken from the opposite right parietal lobe between different spatial positions.

The Simultanagnosie can also occur alone and is then lesions attributable to temporo- occipital regions. The optical ataxia with spatial and visual disturbances such as the deterioration in estimation of distances can occur in isolation and is then a consequence of unilateral injury in the upper Scheitelläppchens. The double-sided lesion frontal regions or the basal ganglia can cause ocular apraxia.

Historical

The Bálint 's syndrome is named after Rezsö Bálint (1874-1929), a Hungarian-Austrian neurologist from Budapest. He is regarded as the first to describe the syndrome. Simultaneously by Inouye originate similar case reports of patients with gunshot wounds. More detailed descriptions of Bálint 's syndrome in people with gunshot wounds come from Holmes.

The patient had bilateral lesions described by Bálint the brain after cerebral infarction at the junction of parietal, temporal and occipital lobes. On the left side of the brain, the cerebral cortex was also affected, for body movement (motor cortex) and body perception ( Somatosensory cortex ) is responsible. Bálint emphasized that the damage on both sides of the gyrus angularis with include, but not the visual cortex. The examination of the brain was performed after the patient's death. He had suffered several strokes in 1894, and which resulted in pronounced described by Bálint symptoms. Bálint examined the patient from 1903 until his decease in 1906.

The patient could see he was able to recognize colors and shapes. It was possible for him, the eyes move in all directions, although his gaze is always 35 ° walked on the object due to the resulting Hemineglectes. The patient had taken an object in the visual field in the eye, he could only perceive this and no more. This narrowing of attention affected thereby all sizes of objects. A complex scene could no longer be overlooked. A text was perceived as disjointed arrangement of individual letters, thus the patient could no longer read. Did the patient to reach for something that interested him, he failed that, so he was completely helpless in everyday life. Bálint describes an example of the failed attempts of the patient to light a cigar. Finally, the patient could also estimate any distance and perceive spatial depth.

The patients described by Holmes suffered mainly due to ocular apraxia. They could set their sights on no object in the visual field align more, regardless of whether they wanted to do this yourself, or have been made ​​aware it was told them of. Had they fixed an object once, so they could recognize this though, but keep in mind difficult. Just as Balint's patient their spatial depth perception was severely disrupted. They ran against objects, could not read and complex situations not detect.