Developmental Gerstmann's syndrome: A distinct clinical entity of learningdisabilities

The symptom complex of finger anemia, right-left disorientation, dysgraphia , and dyscalculia constitutes Gerstmann's syndrome. It is mostly described in adults and is caused by acquired lesions of the dominant parietal lobe. It is infrequently described in children with learning disabilities and has been designated developmental Gerstmann's syndrome. Developmental Gerstman n's syndrome goes unnoticed if not specifically sought by clinicians. A det ailed evaluation will reveal subtle neurologic deficits, behavioral problem s, and neuropsychologic and specific speech and language abnormalities. Ten such patients are reported; six of the children demonstrated improvement w ith intensive speech training, Early identification and intervention is the refore crucial, and even more important in cultures in which students are r equired to be biliterate or triliterate, further increasing the constraints on writing. A selective writing, reading, or calculation abnormality in th e presence of normal oral communication triggers several interesting possib ilities for the brain mechanisms behind normal language processing. Similar ly, the association of acalculia with finger anemia and agraphia with right -left disorientation may have specific implications in the neuropsychologic processing of the evolution of calculation and writing. A theoretical poss ibility of oral and written language processing from the observation of the language behavior of these children is also described. (C) 2000 by Elsevie r Science Inc, All rights reserved.