Gerstmann syndrome is a rare neurological disorder that can occur as the result of a brain injury or as a developmental disorder. It has not been found to run in families. In extremely rare cases, children who are bright and functioning intellectually at a high level may be affected by the disorder as well as those who suffer brain damage.
Gerstmann syndrome is different from Gerstmann-Sträussler-Scheinker syndrome, a rare genetic degenerative brain disorder.
Gerstmann syndrome is a rare disorder characterized by the loss of four specific neurological functions: Inability to write (dysgraphia or agraphia), the loss of the ability to do mathematics (acalculia), the inability to identify one's own or another's fingers (finger agnosia), and inability to make the distinction between the right and left side of the body. It is very rare for a person with learning disabilities to have all four of these neurologic dysfunctions. Only when all four symptoms appear together without mental retardation is the classic syndrome present.
When affected individuals have all four of the characteristic symptoms of Gerstmann syndrome without other cognitive defects, the condition may be referred to as "pure" Gerstmann syndrome. However affected individuals usually have other defects in addition to the classic four findings of Gerstmann syndrome. In addition, many individuals have only two or three of the four key findings in combination with other types of cognitive defects.
In such cases in addition to the four classical symptoms, affected individuals may also have difficulty expressing themselves through speech, and/or difficulty understanding another person's speech (aphasia). They may experience difficulty in reading and spelling as well.
A few cases have been reported in children and called developmental Gerstmann syndrome. These cases usually become apparent when children begin school. Affected children may demonstrate poor handwriting, spelling and math skills (e.g., difficulty adding, subtracting, dividing and multiplying). Some children have difficulty reading or understanding written words (alexia) and difficulty copying or tracing simple objects (constructional apraxia).
Some researchers suggest that developmental Gerstmann syndrome is not a true, unique syndrome, but rather a group of symptoms caused by another, underlying disorder.
The presence in the adult of all four neurological symptoms suggests a diagnosis of Gerstmann syndrome, especially when other causes of these symptoms are ruled out. Among children, most cases are recognized at school age when the affected person has difficulty in math and writing.
Affected children may also have problems in spelling, performing the basic four mathematical calculations, and distinguishing left from right. Also, they generally fail the finger identification test. Many, but not all such children will find it difficult to copy simple drawings (constructional apraxia).
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