Gerstmann Syndrome – Angular Gyrus — SCE Neurology MCQ

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HardNeuro-ophthalmologyGerstmann Syndrome – Angular GyrusSCE Neurology

A 58-year-old woman with a right parietal lobe lesion is found to have a left lower quadrantanopia on Humphrey visual field testing. She also has left-sided hemisensory loss and difficulty with calculations (acalculia). She has a right-left confusion and finger agnosia. What neurological syndrome does she have?

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Correct answer: D — Gerstmann syndrome

Gerstmann syndrome results from a dominant (usually left) parietal lobe lesion, particularly the angular gyrus. The classic tetrad is: (1) acalculia (difficulty with calculations), (2) agraphia (difficulty writing), (3) finger agnosia (inability to identify fingers), and (4) left-right confusion. The left lower quadrantanopia results from involvement of the superior optic radiation fibres in the parietal lobe. However, pure Gerstmann syndrome is rare — individual components are more commonly seen. A: Wernicke aphasia is posterior temporal. C: Anton syndrome is denial of cortical blindness. D: Balint syndrome has simultanagnosia, optic ataxia, and oculomotor apraxia from bilateral parietal lesions. E: Frontal lobe syndrome has behavioural/executive features.

Reference: Clinical Neuroanatomy