Balint's syndrome arising from bilateral posterior cortical atrophy or infarction: rehabilitation strategies and their limitation

Perez, Fabrízzio Martin Pelle; Tunkel, Richard; Lachmann, Elisabeth; Nagler, Willibald

doi:10.3109/09638289609165884

Cited by 52 publications

(24 citation statements)

References 10 publications

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“…Some success has been claimed for intensive rehabilitation. 33 Children with impaired vision due to periventricular leukomalacia commonly show a very similar pattern of visual dysfunction 34 and this is discussed later.…”

Section: Clinical Presentations In Adultsmentioning

confidence: 99%

Cognitive vision, its disorders and differential diagnosis in adults and children: knowing where and what things are

Dutton

2003

Eye

130

127

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Section: Clinical Presentations In Adultsmentioning

confidence: 99%

Cognitive vision, its disorders and differential diagnosis in adults and children: knowing where and what things are

Dutton

2003

Eye

130

127

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“…These techniques have only been attempted with a handful of patients, and reported benefits are modest. PCA patients may benefit from rehab ilitation strategies such as improving symptom understanding, visual scanning training and training to use tactile rather than visual information [38,39]. Wearing yellow glasses, intended to upregulate the magnocellular pathway, has been reported to result in improved contrast sensitivity and subjective amelioration of visual impairment in PCA [40].…”

Section: Cognitive Rehabilitationmentioning

confidence: 98%

Posterior Cortical Atrophy: Advice for Diagnosis and Implications for Management

Shakespeare

Crutch

Fox

2012

Neurodegen. Dis. Manage.

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The clinical presentation of Alzheimer's disease (AD) is heterogeneous, especially in individuals with an early age at onset, where the presenting symptoms may be language, behavior or visual impairment. Posterior cortical atrophy (PCA) refers to a syndrome where visual processing and other posterior functions are the initial symptoms. While the majority of PCA cases reflect the underlying AD, a proportion of cases are caused by dementia with Lewy bodies, corticobasal degeneration or prion disease. PCA is sometimes not recognized until late into the disease or misattributed to anxiety or malingering owing to its low frequency, the early age at onset and the relatively atypical symptoms. This article describes the PCA syndrome, emphasizing its clinical features and how it relates to early-onset AD variants. In order to aid identification of this syndrome, the neuroimaging and neuropsychological features, as well as biomarkers of the underlying pathology, are also described briefly. Finally, the implications for treatment, compensatory strategies and rehabilitation, as well as management of comorbidities, are discussed.The clinical presentation of Alzheimer's disease (AD) is heterogeneous, especially in individuals with an early age at onset.Presenting symptoms of AD may include primary impairments of language, behavior or vision.Posterior cortical atrophy (PCA) is characterized by progressive impairment in visuospatial and visuoperceptual function, alexia, and features of Balint's and Gerstmann's syndrome.The majority of PCA cases are due to AD histopathology; however, dementia with Lewy bodies, cortical basal degeneration and prion disease can all lead to a similar syndrome.In PCA, gray matter atrophy is seen on T 1 MRI in parietal, occipital and occipitotemporal cortices.Biomarkers such as cerebrospinal fluid, amyloid-b:tau ratio and amyloid PET imaging can indicate the underlying pathology.It is important to identify the underlying pathology in view of future protein-specific treatments and trials.It is important to differentiate clinical syndromes in order to provide carers and patients with relevant information and appropriate compensatory or rehabilitative strategies.

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“…SPECT-oder PET-Befunde, die eine überwiegend parietale Minderperfusion zeigen, sind eine wichtige Ergän-zung der Diagnostik [29]. In der Literatur finden sich nur wenige Hinweise zur Therapie [7,45,46] …”

Section: Diagnose Und Behandlungunclassified

Das klinische Syndrom der posterioren kortikalen Atrophie

et al. 2006

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Posterior cortical atrophy (PCA) is a syndrome that involves distinct neuropsychological deficits. This paper presents the clinical and neuropsychological findings recorded in four patients with PCA and reviews the characteristics of the syndrome and other conditions that need to be considered in the differential diagnosis. The cardinal symptoms of PCA are deficits of higher visual and spatial functions (mostly taking the form of Balint's syndrome), variably associated with disorders of visual perception, topographical disorientation, visual object agnosia and prosopagnosia, and deficits affecting reading, copying, drawing, and calculation. PCA is mostly associated with histopathological changes similar to those found in dementia of Alzheimer type (DAT), which are located predominantly in posterior brain regions. Memory and language functions tend to be preserved better and for a longer time in PCA than in the normal variant of DAT. SPECT and PET show deficits of perfusion and metabolism in both parietal and occipital lobes. The diagnosis of PCA is based on neuropsychological and imaging findings.

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Balint's syndrome arising from bilateral posterior cortical atrophy or infarction: rehabilitation strategies and their limitation

Cited by 52 publications

References 10 publications

Cognitive vision, its disorders and differential diagnosis in adults and children: knowing where and what things are

Cognitive vision, its disorders and differential diagnosis in adults and children: knowing where and what things are

Posterior Cortical Atrophy: Advice for Diagnosis and Implications for Management

Das klinische Syndrom der posterioren kortikalen Atrophie

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