title: Balint's syndrome arising from bilateral posterior cortical atrophy or infarction: rehabilitation strategies and their limitation.
abstract: Balint's syndrome is characterized by faulty visual scanning, dysmetria secondary to a visual perceptual deficit, and an inability to recognize more than one object at a time. We report three cases of Balint's syndrome and the individualized rehabilitation they received. One patient developed symptoms of Balint's syndrome caused by bilateral occipitoparietal infarcts. In the two other cases the symptoms arose secondary to posterior cortical atrophy, a slowly progressive dementia with alexia and agraphia. All three patients initially responded to a multicontext treatment approach with intensive verbal cueing and organizational strategies with subsequent improvement in visual recognition, reaching and scanning. Continued deterioration from posterior cortical atrophy or a second infarction resulted in worsening dementia in two patients. Cognitive remediation was required as visual perceptual rehabilitation became ineffective. Clinicians should be familiar with Balint's syndrome and its various aetiologies. Lack of awareness of this syndrome may lead to a misdiagnosis and resulting inappropriate or inadequate treatment.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Staten Island University Hospital North, New York 10305, USA.
authors.forename: F M
authors.initials: FM
authors.lastname: Perez
authors.forename: R S
authors.initials: RS
authors.lastname: Tunkel
authors.forename: E A
authors.initials: EA
authors.lastname: Lachmann
authors.forename: W
authors.initials: W
authors.lastname: Nagler
mesh_terms: D000377:Agnosia / Q000175:diagnosis / Q000209:etiology / Q000266:history / Q000534:rehabilitation*; D001284:Atrophy; D002540:Cerebral Cortex / Q000473:pathology*; D002544:Cerebral Infarction / Q000150:complications*; D015928:Cognitive Behavioral Therapy; D005260:Female; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D008297:Male; D008875:Middle Aged; D013028:Space Perception; D013577:Syndrome; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology / Q000266:history / Q000534:rehabilitation*