Living with Bálint's: A Descriptive, Narrative Account of Two Patients' Adaptations to Living with a Rare and Disabling Visuoperceptual Disorder (P02.036)

Abstract

Objective: To provide a descriptive, narrative account of two patients' own experiences with Bálint syndrome due to bilateral posterior hemispheric ischemic strokes, and to familiarize clinicians and therapists with the functional impairments and subsequent adaptations.

Background Bálint syndrome is a rare and debilitating neurological disorder characterized by optic ataxia, ocular apraxia, and simultanagnosia. It is typically caused by bilateral parieto-occipital lesions in the convexity of the hemispheres.

Design/Methods: We examine the progression from onset to diagnosis and finally ongoing adaptation to the daily difficulties of living with Bálint syndrome for two patients (AS, female, age 68; and JD, male, age 66).

Results: AS initially believed her symptoms were due to an ocular problem, prompting her to seek first consultation with an ophthalmologist. After subsequent neurological consult resulted in proper diagnosis and patient education, AS began to implement a variety of environmental home adaptations. She maintained spatial awareness by keeping in constant contact with bathroom fixtures while attending to her activities of daily living, and by eating with her hands in place of utensils. AS also compensated for her simultanagnosia by placing colored tape around household objects to indicate object type, and for her ocular apraxia by listening to books on tape. Soon after receiving his diagnosis of Bálint syndrome, JD began to relearn basic tasks such as dressing himself and brushing his teeth. Unable to track moving objects, JD performs horizontal pursuit by rotating his head. As his strokes were more recent than AS's, most of JD's practical adaptations are still caretaker-centered. JD is also struggling with labile and depressed moods.

Conclusions: We report two cases of Bálint syndrome from the patients' perspective and describe the impairments and ongoing adaptations accompanying the disorder. The patient's perspective is critical in terms of developing specific rehabilitation research strategies of the visuo-perceptual disorders in Bálint syndrome.

Disclosure: Dr. Cuomo has nothing to disclose. Dr. Flaster has nothing to disclose. Dr. Biller has nothing to disclose.