2019 Volume 39 Issue 3 Pages 373-378
A patient presented with inability to orient the body due to Bálint syndrome and impaired distance judgment caused by damage to the bilateral parietal lobes from grade 2 subcortical hemorrhage. The patient was discharged home from a convalescent rehabilitation ward and continued to receive long-term support via long-term care insurance. Evaluation after 15 months of onset revealed that Bálint syndrome and impaired distance judgment still remained ; however, the patientʼs difficulty in sitting on a chair had decreased. Before sitting on a chair, the patient searched for and touched the seat surface with the upper limbs to estimate the seat width and distance between the patient and the chair. Next, the patient moved the buttocks toward the hand touching the seat surface. The patient also remarked, “I sat down while thinking,” and completed the action by way of conscious processing. Therefore, we recommend repetitive practice of motor output using a residual sensory modality based on somatic sensory information and by conscious processing using offline information processing, such as knowledge and memory. We believe that it is important to provide long-term support through collaborative medical care and nursing care in patients with inability to orient the body due to Bálint syndrome and anosognosia.
