What are the other Names for this Condition? (Also known as/Synonyms)

• Balint-Holmes Syndrome
• Optic Ataxia-Gaze Apraxia-Simultanagnosia Syndrome

What is Balint Syndrome? (Definition/Background Information)

• Balint Syndrome is an uncommon neurologic condition characterized by the presence of the following triad of signs and symptoms, indicting a parietooccipital brain lesion affecting both the left and right side of the brain
• The triad of visual and spatial difficulties constituting Balint Syndrome include:
  • Optic ataxia - difficulty in guiding one’s hand towards an object using visual information
  • Gaze apraxia or oculomotor apraxia (OMA) - is the lack of control of, or difficulty in moving eyes to follow objects (absence of purposeful eye movement)
  • Simultanagnosia - an inability in perceiving more than one objects at a time (or simultaneously)

Who gets Balint Syndrome? (Age and Sex Distribution)

• Balint Syndrome is a very rare disorder; its prevalence is unknown
• Individuals of any age group may be affected; the age category involved may depend on the underlying cause
• Both male and female gender may be affected
• Worldwide, individuals of all races and ethnicity may develop the condition

What are the Risk Factors for Balint Syndrome? (Predisposing Factors)

The predisposing factors for Balint Syndrome may include:

• Bilateral parietooccipital brain lesions
• Brain stroke (usually multiple)
• Alzheimer's disease
• Cerebral adrenoleukodystrophy (CALD)
• Creutzfeldt-Jakob disease (CJD)
• Near drowning events
• Posterior reversible encephalopathy syndrome (PRES)
• Primary CNS angiitis
• Progressive multifocal leukoencephalopathy (PML)
• Reversible cerebral vasoconstriction syndrome (RCVS)
• Subacute HIV encephalitis

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Balint Syndrome? (Etiology)

• The cause of development of Balint Syndrome is unknown. Study research suggests that the condition may occur due to visual signal processing abnormalities
• The factors that cause the condition (damage to the brain) may include brain lesions, neurological conditions, vascular diseases, and brain infections

What are the Signs and Symptoms of Balint Syndrome?

The signs and symptoms of Balint Syndrome may differ from one individual to another, depending on the degree of severity of the condition. The signs and symptoms may include:

• Disability to shift gaze voluntarily
• Inability to move the hand using visual cues
• Inability to perceive multiple objects simultaneously. For example - an individual may see a collection of trees, but may be unable perceive it as a forest
• Difficulty in reading, even though the individual can read letters and words individually, he/she has difficulty in putting together groups of words to elicit coherence

Associated signs and symptoms of the underlying condition/disorder, if any, may also be observed.

How is Balint Syndrome Diagnosed?

The presence of the three key symptoms of optic ataxia, gaze apraxia, and simultanagnosia is necessary for a healthcare provider to diagnose Balint Syndrome.

The diagnosis may involve the following tests and exams:

• Physical exams and medical history evaluations
• Neurological, motor skills, and cognitive assessments
• General and detailed eye exam
• Fundoscopic (ophthalmoscopic) examination by an eye specialist, who examines the back part of the eye (or the fundus)
• Visual acuity test using a special and standardized test chart (Snellen chart)
• Slit-lamp examination
• Visual evoked potential (VEP) test
• Electroencephalogram (EEG), if necessary
• Imaging studies including CT and MRI scans of the head and neck region may be undertaken based on the healthcare provider’s evaluation, in order to rule out other conditions
• Single-photon emission computed tomography (SPECT) imaging study

Additional tests and procedures to diagnose the underlying causative condition may be needed.

A differential diagnosis to eliminate other conditions, such as hemispatial neglect, may be considered, before arriving at a definitive diagnosis.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Balint Syndrome?

The complications of Balint Syndrome may include:

• Difficulty in performing simple day to day tasks 
• Academic and work life may be severely affected
• Increased risk for accidents at work
• Decreased quality of life due to severe disability

Complications arising from the underlying/associated condition, if any present, may be noted.

How is Balint Syndrome Treated?

• A management of Balint Syndrome involves treating the underlying cause
• The individual may need suitable neuropsychological rehabilitation to recover from the underlying neurological condition, which forms an important part of treating the condition

Regular medical screening at periodic intervals with tests and physical examinations are recommended.

How can Balint Syndrome be Prevented?

Presently, it may not be possible to prevent Balint Syndrome. However, the following factors may help lower one’s risk for acquiring the same:

• Undertake prompt diagnosis and treatment of any brain/neurological disorder, including brain tumors and infections
• Avoid the use of recreational drugs
• Wear helmets and safety gear while participating in sports or while driving to prevent head injury

What is the Prognosis of Balint Syndrome? (Outcomes/Resolutions)

The overall prognosis of Balint Syndrome primarily depends on the severity of the underlying condition, which may vary from one individual to another, and one’s response to treatment.

• If the underlying cause is an infection, then the prognosis can be good
• If the underlying cause is Alzheimer’s disease or other progressive neurological conditions, the prognosis may be guarded

Additional and Relevant Useful Information for Balint Syndrome:

Please visit our Eye & Vision Health Center for more physician-approved health information:

https://www.dovemed.com/health-topics/vision-center/