[Gerstmann syndrome].
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A review is given of well documented cases of Gerstmann's syndrome covering one century from 1888 to 1991 complemented by two own observations, Convergencies as well as divergencies are pointed out. It is concluded, that although aphasia may be an accompanying condition, aphasic agraphia as described in linguistic terms is not a sufficient explanation of agraphia in Gerstmann's syndrome which implies spatial-graphic particularities like disturbances of symmetry, reduplications of strokes, defective line orientation, choice of a different letter type and occurrence of nonsense characters not contained in the alphabet. Literal paragraphs may appear as well, while semantic errors are virtually lacking. These features are known to occur in apractic or constructive agraphia whose localisation is usually in the left angular/subangular region coincident with a disconnection from homotopic right hemisphere areas by damage of commissural fibres. Lesions of these non-dominant areas may lead to spatial agraphia.
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Fourteen (14) dyscalculic school children were drawn from a larger population of learning-disabled children. The subjects were divided into two groups, those with normal-or-better reading ability and those with dyslexia equal in degree to their dyscalculia. Both groups showed a variety of behavioral deficits in addition to those comprising Gerstmann's syndrome and were notably poor in auditory and visual discrimination and motor coordination. Good readers showed severely-impaired ability to make right-left discriminations, while the poor readers were average in this ability. Poor readers showed marked impairment of word fluency and hand writing, while good readers were average in this regard. The dyscalculia and reading deficits reported here appear unrelated to central-language impairment. Subjects with all four elements of the developmental Gerstmann's syndrome did not constitute an homogeneous behavioral group and were found among samples of both good and poor readers. The pattern of behavioral deficits shown by these subjects suggests cerebral impairment rather than slow maturation as a probable etiology. While the DGS is not useful as a behavioral description, its value as a possible localizing neurological sign cannot yet be ruled out.
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