Gerstmann syndrome is a neurological

Neurology

Neurology is a medical specialty dealing with disorders of the nervous system. Specifically, it deals with the diagnosis and treatment of all categories of disease involving the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all effector tissue,...

 disorder that is characterized by a constellation of symptoms that suggests the presence of a lesion

Lesion

A lesion is any abnormality in the tissue of an organism , usually caused by disease or trauma. Lesion is derived from the Latin word laesio which means injury.- Types :...

 in a particular area of the brain. (It should not be confused with Gerstmann-Sträussler-Scheinker syndrome

Gerstmann-Sträussler-Scheinker syndrome

Gerstmann–Sträussler–Scheinker syndrome is a very rare, usually familial, fatal neurodegenerative disease that affects patients from 20 to 60 years in age...

, which is a transmissible spongiform encephalopathy

Transmissible spongiform encephalopathy

Transmissible spongiform encephalopathies , also known as prion diseases, are a group of progressive conditions that affect the brain and nervous system of many animals, including humans. According to the most widespread hypothesis they are transmitted by prions, though some other data suggest an...

.)

It is named for Josef Gerstmann

Josef Gerstmann

Josef Gerstmann was an Austrian neurologist.Gerstmann syndrome and Gerstmann-Sträussler-Scheinker syndrome are named after him....

.

Primary symptoms

Gerstmann syndrome is characterized by four primary symptoms:

1. Dysgraphia
   Dysgraphia
   Dysgraphia is a deficiency in the ability to write primarily in terms of handwriting, but also in terms of coherence. It occurs regardless of the ability to read and is not due to intellectual impairment...
   
   /agraphia: deficiency in the ability to write
2. Dyscalculia
   Dyscalculia
   Dyscalculia is a specific learning disability involving innate difficulty in learning or comprehending simple arithmetic. It is akin to dyslexia and includes difficulty in understanding numbers, learning how to manipulate numbers, learning maths facts, and a number of other related symptoms...
   
   /acalculia: difficulty in learning or comprehending mathematics
3. Finger agnosia: inability to distinguish the fingers on the hand
4. Left-right disorientation

Causes

This disorder is often associated with brain

Brain

The brain is the center of the nervous system in all vertebrate and most invertebrate animals—only a few primitive invertebrates such as sponges, jellyfish, sea squirts and starfishes do not have one. It is located in the head, usually close to primary sensory apparatus such as vision, hearing,...

 lesions in the dominant (usually left) hemisphere including the angular

Angular gyrus

The angular gyrus is a region of the brain in the parietal lobe, that lies near the superior edge of the temporal lobe, and immediately posterior to the supramarginal gyrus; it is involved in a number of processes related to language, mathematics and cognition...

 and supramarginal gyri

Supramarginal gyrus

The supramarginal gyrus is a portion of the parietal lobe. It is probably involved with language perception and processing, and lesions in it may cause Wernicke's aphasia or transcortical sensory aphasia.-External links:...

 near the temporal

Temporal lobe

The temporal lobe is a region of the cerebral cortex that is located beneath the Sylvian fissure on both cerebral hemispheres of the mammalian brain....

 and parietal lobe

Parietal lobe

The parietal lobe is a part of the Brain positioned above the occipital lobe and behind the frontal lobe.The parietal lobe integrates sensory information from different modalities, particularly determining spatial sense and navigation. For example, it comprises somatosensory cortex and the...

 junction. There is significant debate in the scientific literature as to whether Gerstmann Syndrome truly represents a unified, theoretically motivated syndrome. Thus its diagnostic utility has been questioned by neurologists and neuropsychologists alike. The angular gyrus is generally involved in translating visual patterns of letter and words into meaningful information, such as is done while reading.

In adults

In adults, the syndrome may occur after a stroke

Stroke

A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...

 or in association with damage to the parietal lobe

Parietal lobe

The parietal lobe is a part of the Brain positioned above the occipital lobe and behind the frontal lobe.The parietal lobe integrates sensory information from different modalities, particularly determining spatial sense and navigation. For example, it comprises somatosensory cortex and the...

.

In addition to exhibiting the above symptoms, many adults also experience aphasia

Aphasia

Aphasia is an impairment of language ability. This class of language disorder ranges from having difficulty remembering words to being completely unable to speak, read, or write....

, which is a difficulty in expressing oneself when speaking, in understanding speech, or in reading and writing

Writing

Writing is the representation of language in a textual medium through the use of a set of signs or symbols . It is distinguished from illustration, such as cave drawing and painting, and non-symbolic preservation of language via non-textual media, such as magnetic tape audio.Writing most likely...

.

In children

There are few reports of the syndrome, sometimes called developmental Gerstmann syndrome, in children. The cause is not known. Most cases are identified when children reach school age, a time when they are challenged with writing and math exercises. Generally, children with the disorder exhibit poor handwriting and spelling skills, and difficulty with math functions, including adding, subtracting, multiplying, and dividing. An inability to differentiate right from left and to discriminate among individual fingers may also be apparent. In addition to the four primary symptoms, many children also suffer from constructional apraxia, an inability to copy simple drawings. Frequently, there is also an impairment in reading. Children with a high level of intellectual functioning as well as those with brain damage may be affected with the disorder.

Treatment

There is no cure for Gerstmann syndrome. Treatment is symptomatic and supportive. Occupational and speech therapies may help diminish the dysgraphia and apraxia

Apraxia

Apraxia is a disorder caused by damage to specific areas of the cerebrum. Apraxia is characterized by loss of the ability to execute or carry out learned purposeful movements, despite having the desire and the physical ability to perform the movements...

. In addition, calculator

Calculator

An electronic calculator is a small, portable, usually inexpensive electronic device used to perform the basic operations of arithmetic. Modern calculators are more portable than most computers, though most PDAs are comparable in size to handheld calculators.The first solid-state electronic...

s and word processor

Word processor

A word processor is a computer application used for the production of any sort of printable material....

s may help school children cope with the symptoms of the disorder.

Prognosis

In adults, many of the symptoms diminish over time. Although it has been suggested that in children symptoms may diminish over time, it appears likely that most children probably do not overcome their deficits, but learn to adjust to them.

External links