Gerstmann syndrome is a disorder associated with a variety of cognitive impairments. However, the intelligence of affected individuals is not reduced. In the context of Gerstmann syndrome, even simple tasks in everyday life may pose a problem for patients.
What is Gerstmann syndrome?
Gerstmann syndrome summarizes an extensive complex of diverse complaints and symptoms. The first describer of the phenomenon is Gerstmann, who analyzed the condition in 1924. Typical signs of Gerstmann syndrome are, for example, an acalculia, i.e. a weakness in arithmetic despite average intelligence. In addition, in many cases the affected individuals suffer from agraphia. This means that they find it difficult to write, although there are no disturbances in motor function or reductions in intelligence. Numerous patients with Gerstmann’s syndrome also exhibit a so-called left-right weakness, meaning that they very often confuse the two directions or terms in everyday life. Another typical symptom of Gerstmann syndrome is finger and toe agnosia. In this context, individuals have problems recognizing or naming their toes and fingers. In some circumstances, Gerstmann syndrome is referred to by the synonymous term angularis syndrome. However, strictly speaking, this disease term is a more narrowly defined condition. For this reason, the synonymous use of the terms is criticized by some physicians. In the majority of cases, the symptoms of Gerstmann syndrome appear in the context of other diseases. In most cases, these are symptoms that occur together with other neurological impairments. Such disorders are possible, for example, due to damage to the brain caused by accidents or other causes. The typical symptoms of Gerstmann syndrome are also possible after a stroke. In principle, an isolated occurrence of Gerstmann syndrome is rare. For this reason, it is still debated whether Gerstmann syndrome is a disorder in its own right that is suitable as a sole diagnosis. In most cases, Gerstmann syndrome does not occur in its pure form, i.e. without neurological disorders as well as apraxia and acalculia. In some cases, other potential causes for the typical complaints are found, for example, impairments in working memory.
Causes
The causes of Gerstmann syndrome are primarily due to damage (medical term lesions) to the brain. For example, in some cases, a stroke triggers the characteristic symptoms of Gerstmann syndrome. This is especially the case if the angular gyrus or the supramarginal gyrus are affected by the damage in the course of the stroke. Other potential causes of Gerstmann syndrome include injuries to the brain or tumors.
Symptoms, complaints, and signs
The typical symptoms and complaints of Gerstmann syndrome usually make it appear at first glance that the affected person is suffering from decreased intelligence. However, this is actually not the case, because the patients of Gerstmann syndrome have an averagely high intelligence quotient in the majority of cases. Characteristics of Gerstmann syndrome are, for example, problems in distinguishing and naming the toes and fingers. For example, affected individuals cannot immediately distinguish the ring finger from the index finger and find the correct term for it. The same applies to the directions right and left, which the patient often confuses with each other on both a linguistic and motor level. In addition, there are complaints such as acalculia and agraphia, i.e. problems with arithmetic and writing. Both of these symptoms present without cognitive or motor reasons being apparent.
Diagnosis
If the characteristic symptoms and complaints of Gerstmann syndrome accumulate and affect the quality of life of the affected person, consultation with a physician is recommended. Initially, the primary care physician is a suitable contact. Possibly, the patient will be referred to a neurologist. The first step in making a diagnosis is to take the patient’s medical history. In this conversation, all complaints are discussed. In addition, the patient describes his or her life circumstances and any past illnesses or accidents.For example, a past stroke indicates Gerstmann syndrome. After the discussion, various examinations are usually performed to diagnose Gerstmann syndrome. A tentative diagnosis is already made based on the characteristics described. If the patient suffers from the typical symptoms without being mentally retarded or having impaired intelligence, the presence of Gerstmann syndrome is relatively likely. A differential diagnosis must also be performed. Similar disorders include developmental Gerstmann’s syndrome or Gerstmann-Sträussler-Scheinker syndrome.
Complications
Gerstmann’s syndrome extremely reduces the patient’s quality of life and makes everyday life very difficult. As a rule, the affected person is dependent on the help of other people in everyday life and can no longer perform a variety of tasks by himself. Cognitive abilities in particular are impaired. Intelligence is not impaired by Gerstmann syndrome, so there is no retardation. However, it is not uncommon for psychological complaints and complications to occur due to the limitations. These psychological complaints may also affect the patient’s parents and relatives. In most cases, there are problems with speech and thinking, so that, for example, calculating with numbers or naming certain objects cannot be done easily. Writing may also be restricted. A causal therapy of Gerstmann syndrome is not possible in most cases. For this reason, only the symptoms are treated. This does not lead to further complications and can often limit the symptoms. The patient’s quality of life is not reduced by Gerstmann syndrome. If Gerstmann syndrome has occurred after a stroke, the further course of the disease also depends on the causes and consequences of the stroke.
When should you see a doctor?
In the case of Gerstmann syndrome, a doctor must be consulted in any case. This can prevent further complications in adulthood. A doctor should be seen if the child suffers from significantly decreased intelligence due to Gerstmann syndrome. This complaint can be diagnosed as early as kindergarten or school. The earlier Gerstmann syndrome is diagnosed and treated, the higher the chances of a positive course of the disease. Especially simple activities, such as naming left and right or naming the individual fingers can cause difficulties for the affected person. If these symptoms occur, a doctor must be consulted. The right contact persons are the general practitioner or a pediatrician. However, further treatment of Gerstmann syndrome is carried out by a neurologist. Since in some cases the syndrome can also lead to psychological complaints in the children or also in the parents, psychological treatment should also be carried out.
Treatment and therapy
As part of the therapy of Gerstmann syndrome, the focus is on treating or eliminating the underlying disease or cause. This is because the symptoms that occur individually are also highly dependent on the reasons for their occurrence. If a person suffers a stroke, the symptoms usually become noticeable very quickly. However, there is a possibility of regression of the symptoms of the disease, especially if the patient receives regular occupational therapy. In some circumstances, logopedic therapy is also useful and alleviates the symptoms over time.
Outlook and prognosis
The prognosis of Gerstmann syndrome depends on the presenting problems or disorders. The syndrome is not a disease in its own right and is therefore diagnosed as a result of another irregularity. As a result, the treatment plan is not focused on curing Gerstmann syndrome but on treating the original disorder. Cognitive performance is diminished in the syndrome. They are supported in various and individually compiled support measures. This leads to an alleviation of the symptoms and at the same time to an improvement of the well-being. In a large number of the underlying diseases present, there is no cure. As a result, freedom from the symptoms of Gerstmann syndrome cannot take place.In many cases, despite all efforts, the affected person is dependent on daily support and care in everyday life. It is often not possible to cope with the tasks without help. The overall situation can lead to further secondary diseases. Psychological disorders are often diagnosed, as a drastic change in lifestyle has occurred. If Gerstmann syndrome occurs as an accompanying symptom of a stroke, the patients suffer not only cognitive but also motor losses, which are usually difficult to cope with. Depending on the extent of the underlying disease, there may also be a significant reduction in average life expectancy.
Prevention
Measures for direct prevention of Gerstmann syndrome do not exist, since the disorder is always the result of another underlying disease or other cause. Adequate therapy often shows good results.
Follow-up
The options for aftercare are very limited in Gerstmann syndrome in most cases. In this case, the affected person is primarily dependent on direct medical treatment by a physician so that further complications can be prevented. Self-healing does not occur with this disease, so that treatment is always necessary. The options for treatment are severely limited and usually depend on the exact manifestations and nature of the symptoms. If a stroke has occurred in Gerstmann syndrome, a complete cure is usually no longer possible. The affected persons are dependent on the support and care of relatives and friends to alleviate the symptoms and to enable a proper everyday life. Likewise, some of the discomfort can be alleviated through physical therapy. Many of the exercises from this treatment can also be performed in the patient’s own home to speed healing. Contact with other sufferers can also be very useful in this process. It is possible that the life expectancy of the affected person is reduced due to Gerstmann syndrome. Often, empathetic conversations with one’s own family are also very useful.
What you can do yourself
In many cases, those affected by Gerstmann syndrome are dependent on the help of other people in their daily lives. In this context, loving care by friends and relatives in particular can have a very positive effect on the course of the disease. However, many families are dependent on caregivers due to the syndrome. In most cases, the care involves all aspects of everyday life, as the affected persons suffer from paralysis and other cognitive disorders. They are equally dependent on regular occupational therapy, with exercises that can often be repeated at home. Speech therapy is also often helpful in this regard and can also be accompanied with exercises at home. However, a direct and causal treatment of Gerstmann syndrome is not possible. If the syndrome also leads to psychological complaints or depression, a visit to a psychologist is suitable. Talking to your partner, family or friends can also help. Contact with other people affected by Gerstmann syndrome also has a positive effect on the course of the disease and can contribute to the exchange of information. However, further treatment and the course of Gerstmann syndrome depend very much on the underlying disease.