What is the pathophysiology of Balint syndrome in posterior cerebral artery (PCA) stroke?

Updated: Jul 30, 2018
  • Author: Erek K Helseth, MD; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

This may occur with bilateral parieto-occipital infarction, most often in the watershed between the PCA and middle cerebral artery (MCA) territories. It is a triad of visual simultanagnosia, optic ataxia, and apraxia of gaze, which are characterized as follows:

  • Visual simultanagnosia - Implies an inability to examine a scene and integrate its parts into a cohesive interpretation; a patient can identify specific parts of a scene but cannot describe the entire picture

  • Optic ataxia - Implies a loss of hand-eye coordination such that reaching or performing a motor task under visual guidance is clumsy and uncoordinated

  • Apraxia of gaze - A misnomer describing a supranuclear deficit in the ability to initiate a saccade on command


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