Diagnosing Gerstmann’s syndrome in a case of hypoxic brain injury

Abstract

Objectives: Gerstmann’s syndrome (GS) is characterised by the cooccurrence of acalculia, finger agnosia, agraphia and left-right disorientation. Although there is a relatively large literature on the syndrome’s theoretical implications, less consideration has been given to the assessment of the syndrome in practice. We aimed to provide an illustrative case study of the differential diagnosis of GS.Methods: We describe a case of a 46-year-old woman who presented with the four classic symptoms of GS following a cardiac arrest. In addition to a standard neuropsychological assessment battery, an additional dedicated brief assessment was conducted to differentiate between GS and alternative possibilities.Results: The assessment revealed specific impairments in performing calculations, finger agnosia, agraphia and left-right disorientation, which could not be accounted for by alternative explanations, including a general cognitive impairment, dysphasia, apraxia, Balint’s syndrome, unilateral spatial neglect or object agnosia.Conclusions: The present article provides an illustrative case study of the differential diagnosis of Gerstmann’s syndrome, highlighting how the syndrome may be assessed in clinical practice.