title: [Gerstmann's syndrome in a 9 year old boy].
abstract: BACKGROUND
  Gerstmann's syndrome encompasses the tetrad of finger agnosia, agraphia, acalculia and right-left confusion and is associated with lesions of the left angular gyrus, situated at the confluence of the temporal, parietal and occipital lobes. The localizing value of this syndrome has been questioned because multiple mechanisms can account for each of the four components of the syndrome. This clinical association is infrequent in children and it is impossible to diagnose in early stages of life because of parietal lobes have a slow functional development during childhood.
  
  
  METHODS
  We present the case of a learning disabled boy, 9 year old and right handed, who developed Gerstmann's syndrome. Acalculia, right-left disorientation, agraphia and finger agnosia were clearly identified by neuropsychological studies at this time, but there was no evidence of this dysfunction when he was first studied being 5 year old. This patient had perinatal asphyxia and suffered from focal clonic seizures in early neonatal period. In this case, a infarcted lesion was found at the confluence of parietal and occipital lobes in cranial CT an MRI scans.
  
  
  CONCLUSIONS
  We conclude that is very important to identify this syndrome during childhood using a wide range of neuropsychological tests in order to diminish learning disorders with an early psychopedagogic supervision.
authors.affiliation: Servicio de Psiquiatría/Psicología, Hospital Niño Jesús, Madrid, España.
authors.forename: C
authors.initials: C
authors.lastname: Fournier del Castillo
authors.forename: J J
authors.initials: JJ
authors.lastname: García-Peñas
authors.forename: L G
authors.initials: LG
authors.lastname: Gutiérrez-Solana
authors.forename: M L
authors.initials: ML
authors.lastname: Ruiz-Falcó Rojas
mesh_terms: D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis; D005862:Gerstmann Syndrome / Q000175:diagnosis*; D006801:Humans; D007859:Learning Disabilities / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D010296:Parietal Lobe / Q000000981:diagnostic imaging* / Q000473:pathology*; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed