Gerstmann's Syndrome

What is Gerstmann's Syndrome?

Gerstmann syndrome is a rare neurological syndrome that affects four key abilities: doing mental arithmetic (acalculia), writing out your thoughts (agraphia), distinguishing between left and right (left-right disorientation) and being able to recognise your own and other people’s fingers (finger agnosia). Also known as GS, Gerstmann syndrome can affect children and adults. Most adults are affected as a result of a traumatic brain injury or a stroke.

Gerstmann syndrome is not the same as Gerstmann-Straussler-Scheinker syndrome.

What is the cause of Gerstmann syndrome?

In children, the cause of Gerstmann syndrome is often unknown, but brain damage may be a potential cause in some cases. In adults, brain injuries and conditions that affect blood supply to the brain, such as strokes, are usually identified as the cause. Gerstmann syndrome specifically affects the parietal lobes. These lobes are concerned with sensation and feeling as well as the processing of sensory stimuli.

What are the symptoms of Gerstmann syndrome?

The symptoms of Gerstmann syndrome occur as a result of damage to the parietal lobes and include:

• difficulty differentiating between the left and right sides of the body (known as left-right disorientation)
• difficulty recognising you own and other people’s fingers (known as finger agnosia)
• difficulty expressing your thoughts on paper and writing down what you are thinking (known as agraphia)
• difficulty doing mental arithmetic (known as acalculia)

Additionally, people with Gerstmann syndrome may also struggle to express themselves in spoken word and to understand other people’s speech. Reading and spelling can also cause problems.

In children, Gerstmann syndrome may be described as developmental Gerstmann syndrome. In this case, symptoms usually become most noticeable when children reach school age. Children may experience trouble with reading, handwriting, calculating maths problems and copying and tracing outlines and pictures.

How is Gerstmann syndrome diagnosed?

Some symptoms of Gerstmann syndrome are similar to other conditions, such as Alzheimer’s disease; tests can help to rule out other possible causes of symptoms. However, it is rare to experience all four of the key characteristics of Gerstmann syndrome and therefore if all these symptoms are present, it is very likely that a diagnosis of Gerstmann syndrome will be made. In children, symptoms tend to become apparent when children start school.

Who is affected?

Gerstmann syndrome affects both males and females. The exact number of people affected is not known.

How is Gerstmann syndrome treated?

Treatment for Gerstmann syndrome in children is focused on encouraging development and providing support to help children at school. Children may receive extra help with speech, language, writing, reading and extra tuition in Maths and English. In adults, treatment will depend on the underlying cause. If the brain is damaged as a result of trauma or there is a tumour present, surgery may be required. It is possible for symptoms to become less profound with time.

What is the outlook?

With the right treatment, cases of Gerstmann syndrome can improve and early treatment has been shown to be most effective.