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15 - Bálint's syndrome

Published online by Cambridge University Press:  10 October 2009

By
Alain Vighetto  and
Pierre Krolak-Salmon
Edited by
Olivier Godefroy  and
Julien Bogousslavsky
Alain Vighetto
Affiliation:
Hôpital neurologique Pierre Wertheimer, Lyon and Université Claude Bernard Lyon I
Pierre Krolak-Salmon
Affiliation:
Hôpital neurologique Pierre Wertheimer, Lyon and Université Claude Bernard Lyon I
Olivier Godefroy
Affiliation:
Université de Picardie Jules Verne, Amiens
Julien Bogousslavsky
Affiliation:
Université de Lausanne, Switzerland
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Summary

Introduction

Bálint's syndrome is a clinical entity which combines variously a set of complex spatial behavior disorders following bilateral damage to the occipital–parietal junction. The core syndrome is a triad, namely optic ataxia, gaze apraxia, and simultanagosia, to which visual–spatial perception deficits can be associated. Both diversity of terminology used in literature and bias in clinical descriptions, which often reflect a particular opinion of the authors on underlying mechanisms, add to the difficulty in describing and comprehending this rare and devastating syndrome. As the components are not elementary symptoms, and as they are not necessarily present in each case, indicating they do not rely upon a single brain mechanism, validity of the complex as a syndrome has been questioned (Rizzo and Vecera, 2002). Despite these flaws, Bálint's syndrome can be identified at the bedside examination and it allows robust anticipation of lesion localization.

Historically, Bálint provided in 1909 a thorough clinical and postmortem description of a patient who exhibited hitherto undescribed symptoms, he named Seelenlähmung des “Schauens,” optische Ataxie, raümliche Störung der Aufmerksamkeit, usually translated as psychic paralysis of gaze, optic ataxia, and spatial disorder of attention. He related these symptoms to a bilateral area of ischemic suffering in the posterior parietal and anterior occipital regions, including the angular gyrus and underlying white matter on both sides. In Bálint's view, psychic paralysis of gaze was a consequence of attention impairment and not of eye movement disorder per se; meanwhile optic ataxia was explained in terms of disconnection between visual and motor centers.

Type
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The Behavioral and Cognitive Neurology of Stroke , pp. 294 - 314
Publisher: Cambridge University Press
Print publication year: 2007

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  • Bálint's syndrome
    • By Alain Vighetto, Hôpital neurologique Pierre Wertheimer, Lyon and Université Claude Bernard Lyon I, Pierre Krolak-Salmon, Hôpital neurologique Pierre Wertheimer, Lyon and Université Claude Bernard Lyon I
  • Edited by Olivier Godefroy, Université de Picardie Jules Verne, Amiens, Julien Bogousslavsky, Université de Lausanne, Switzerland
  • Book: The Behavioral and Cognitive Neurology of Stroke
  • Online publication: 10 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544880.016
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  • Bálint's syndrome
    • By Alain Vighetto, Hôpital neurologique Pierre Wertheimer, Lyon and Université Claude Bernard Lyon I, Pierre Krolak-Salmon, Hôpital neurologique Pierre Wertheimer, Lyon and Université Claude Bernard Lyon I
  • Edited by Olivier Godefroy, Université de Picardie Jules Verne, Amiens, Julien Bogousslavsky, Université de Lausanne, Switzerland
  • Book: The Behavioral and Cognitive Neurology of Stroke
  • Online publication: 10 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544880.016
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  • Bálint's syndrome
    • By Alain Vighetto, Hôpital neurologique Pierre Wertheimer, Lyon and Université Claude Bernard Lyon I, Pierre Krolak-Salmon, Hôpital neurologique Pierre Wertheimer, Lyon and Université Claude Bernard Lyon I
  • Edited by Olivier Godefroy, Université de Picardie Jules Verne, Amiens, Julien Bogousslavsky, Université de Lausanne, Switzerland
  • Book: The Behavioral and Cognitive Neurology of Stroke
  • Online publication: 10 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544880.016
Available formats
×