Gerstmann's Syndrome and Aphasia

Abstract

An unselected group of 50 patients with cerebral disease was examined: 21 patients with left-sided, 12 with right-sided and 17 with bilateral lesions. The patients were given tests of right-left orientation, finger localization, arithmetic calculation, writing, reading, verbal memory, an examination for aphasia and a test for constructional praxis. In contradiction to Gerstmann's view, the so-called Gerstmann syndrome does not occur in an isolated form. Instead, it is regularly accompanied by concurrent neuropsychological deficits. The correlation study proved that the four Gerstmann symtoms are no closer connected to each other than to a number of various other deficits. The occurrence of less than 3 Gerstmann symptoms has little localizing value. Only 3 or 4 Gerstmann symptoms indicate a left-sided brain lesion. The complete “Gerstmann syndrome” however is rarely observed without aphasia. It is suggested that aphasia is the common denominator of the four symptoms. The performances which are disturbed in the so-called Gerstmann syndrome are closely related to language. However, aphasia also produces other behavioral deficits, appearing as “concurrent” symptoms. It is therefore not justified to regard the four symptoms as a natural syndrome. They are an arbitrary partial grouping of the numerous neuropsychological disturbances resulting from lesion of the leading hemisphere.