A proposed reinterpretation of Gerstmann's syndrome.
Gerstmann's syndrome includes the clinical tetrad of finger agnosia, agraphia, acalculia, and right-left confusion. Some disagreement remains with regard to the exact localization of the syndrome, but most probable it involves the left angular gyrus with a subcortical extension. Several authors have suggested that a defect in mental spatial rotations could simultaneously account for acalculia, right-left disorientation, and finger agnosia. It has been also suggested that semantic aphasia is always associated with acalculia; as a matter of fact, left angular gyrus has a significant involvement in semantic processing. In this paper, it is proposed that Gerstmann's syndrome should include: acalculia, finger agnosia, right-left disorientation, and semantic aphasia, but not agraphia. When the pathology extends toward the superior parietal gyrus, agraphia can be found. A fundamental defect (i.e., an impairment in verbally mediated spatial operations) could explain these apparently unrelated clinical signs.
Department of Communication Sciences and Disorders, Florida International University, Miami, FL, USA ardilaa@fiu.edu.
Alfredo
A
Ardila
D005862:Gerstmann Syndrome / Q000473:pathology / Q000503:physiopathology*; D006801:Humans
Acalculia; Angular gyrus syndrome; Finger agnosia; Gerstmann's syndrome; Semantic aphasia