Balint’s syndrome (psychic paralysis of visual fixation) and its minor forms. Brain ‘7’7

IN 1909 Balint described a syndrome which he called "psychic paralysis-of visual fixation, " in which the disturbance of fixation occurred in associa-tion with an "optic ataxia " and a disturbance of visual attention. This syndrome, as described by Balint, has appeared in the literature very rarely. Only one observation of Gordon Holmes (1918) and one observation' published by us (1950) seem (to accord with the original description of the German author. The patient described by Balint showed three kinds of disturbances: (1) Psychic paralysis of visual fixation is apparent in the patient's in-ability to look towards a point which is in his peripheral visual field. The author justifies his term of "psychic paralysis " by the fact that, in certain, circumstances, when higher psychological functions are not involved, ocular motility is found to be normal. (2) "Optic ataxia " can be elicited by the whole range of tests which are designed to examine the patient's ability to execute co-ordinated voluntary movements in response to visual stimuli. The author compared the failure of visual control in this case with the impaired proprioceptive control of the-tabetic. In fact, the latter partly corrects his ataxia when he is permitted on sight instead of on his defective proprioception. Balint's patient, on the other hand, executed certain movements correctly under proprioceptive control despite his inability to control movements visually. (3) Disturbance of attention: The patient's attention is normal for all non-visual stimuli; for visual stimuli, however, there is general impair-ment of attention. Consequently only the most prominent stimuli (namely those at the macula) actually reach consciousness. The others (at the periphery) are not seen by the patient, although his "absolute " visual field is normal and the peripheral visual apparatus is capable of normal function. Moreover, this disturbance was more noticeable for the left side than for-by guest on Septe