Understanding Gerstmann Syndrome

The brain is one of the most important organs in the body. Not only does it control our thoughts, but it is responsible for our movement, memory, and speech. Without it, we would cease to exist. The brain is made up of different parts, including the cerebrum, cerebellum, and brainstem. Brain damage, such as that which causes Gerstmann syndrome, can have severe consequences for the entire body.

What is Gerstmann Syndrome?

Gerstmann syndrome describes a cluster of neurological symptoms that result from damage to a certain part of the brain. Despite being a disorder, some doctors have begun to question its existence as a distinct clinical entity because individuals rarely display all of the symptoms at one time. It is important not to confuse the disorder with Gerstmann-Straussler-Scheinker disease, a rare genetic degenerative brain condition.

The Syndrome is Named After Josef Gerstmann

Josef Gerstmann first described the syndrome in 1924. An Austrian-born neurologist, he completed his medical degree at the Medical University in Vienna. After emigrating to the United States in the late 1930s, Gerstmann worked at several institutes including Ohio State Hospital, St. Elisabeth Hospital, and Goldwater Memorial Hospital. For several years, he also worked as a research associate. In addition to describing Gerstmann Syndrome, he is one of the first physicians to have reported Gerstmann-Straussler-Scheinker Syndrome in 1936.

Core Symptoms of Gerstmann Syndrome

Gerstmann syndrome is a neuropsychiatric disorder that causes four core symptoms. These include an inability to perform basic calculations such as addition, subtraction, and multiplication, an inability to identify fingers, left-right confusion, and an inability to communicate through writing. Adults with the condition may also exhibit aphasia—an inability to comprehend or communicate verbally with language. In some cases, an individual may only exhibit two or three of the key symptoms.

Adults Can Develop an Acquired Form

Some adults develop an acquired form of Gerstmann syndrome, which can arise if there is bleeding into specific parts of the brain as a result of traumatic head injury or stroke. More specifically, it is due to lesions in the parietal lobe—the part of the brain involved with perception and sensation—of the dominant hemisphere.

Children Can Have a Developmental Form

Although the syndrome is more common in adults, it can also appear in children. A type of learning disability, Gerstmann syndrome often becomes apparent when children reach school age. In addition to facing challenges with math and writing, many have trouble with spelling, reading, and copying simple drawings. Sometimes, they may also have difficulty differentiating right from left.

Causes of Gerstmann Syndrome

The most common cause of Gerstmann syndrome in adults is brain damage due to traumatic head injury or stroke. Unfortunately, researchers have yet to identify a specific cause of developmental Gerstmann syndrome in children. However, the fact that it affects both parietal lobes (as opposed to one in adults) suggests that the problem may arise during early brain development. There is no evidence that Gerstmann syndrome is hereditary.

Diagnosis of Gerstmann Syndrome

In adults, the presence of all four neurological symptoms suggests a diagnosis of Gerstmann syndrome. To confirm, doctors will often conduct a comprehensive neurological exam requiring the performance of various tests. In children, doctors usually detect Gerstmann syndrome after it becomes apparent they have trouble with tasks such as reading and writing at school.

Treating Gerstmann Syndrome

Unfortunately, there is no cure for Gerstmann syndrome. However, occupational and speech therapies can have a positive effect on an individual’s symptoms. In children, accommodations in the classroom play a role in assuring success. For instance, the use of calculators and word processors can alleviate many of the challenges children with Gerstmann syndrome face.

Special Concerns in those with Gerstmann Syndrome

Individuals with Gerstmann syndrome, particularly children, may be prone to low self-esteem; this often stems from their inability to perform certain tasks. For this reason, it is vital to provide them with adequate support.

Prognosis

Gerstmann syndrome is a permanent disorder that will last a lifetime. However, it is not uncommon for some of the symptoms to diminish over time in adults. While the developmental form of the condition is unlikely to improve or “heal,” many individuals adapt and lead normal lives.