Balintâ€™s Syndrome â€“ an unusual presentation of Alzheimerâ€™s disease
Patients with cognitive problems usually present to medical attention because of concern from relatives. Lack of insight though far from universal in patients with cognitive disturbance, is a very characteristic feature. This is self evident and what follows conversely is also of diagnostic utility ie if the patient self refers to a doctor complaining of cognitive problems, the problem is much more likely to psychological than neurological in origin.
Cognition, a distributed function, has several aspects that can be clearly dissected out by a careful history. For example, patients who repeat themselves frequently and are unable to retain new information are said to have an amnestic pattern of disturbance, which usually localises to the temporal lobes. Cognitive deficits such as apathy, difficulty in processing and set shifting between tasks reliably points towards a subcortical rather than cortical localisation. Patterns of cognitive disturbance can be anatomically classified with a degree of localising accuracy more commonly associated with â€œstandardâ€ neurological symptoms such as weakness or unsteadiness