Gerstmann's Syndrome The combination of acalculia (impairment of simple arithmetic), dysgraphia (impaired writing), finger anomia (an inability to name individual fingers such as the index or thumb), and right-left confusion (an inability to tell whether a hand, foot, or arm of the patient or examiner is on the right or left side of the body) is known as Gerstmann's syndrome. In making this diagnosis it is important to establish that the finger and left-right naming deficits are not part of a more generalized anomia and that the patient is not otherwise aphasic. When Gerstmann's syndrome is seen in isolation, it. | Chapter 027. Aphasia Memory Loss and Other Focal Cerebral Disorders Part 7 Gerstmann s Syndrome The combination of acalculia impairment of simple arithmetic dysgraphia impaired writing finger anomia an inability to name individual fingers such as the index or thumb and right-left confusion an inability to tell whether a hand foot or arm of the patient or examiner is on the right or left side of the body is known as Gerstmann s syndrome. In making this diagnosis it is important to establish that the finger and left-right naming deficits are not part of a more generalized anomia and that the patient is not otherwise aphasic. When Gerstmann s syndrome is seen in isolation it is commonly associated with damage to the inferior parietal lobule especially the angular gyrus in the left hemisphere. Aprosodia Variations of melodic stress and intonation influence the meaning and impact of spoken language. For example the two statements He is clever. and He is clever contain an identical word choice and syntax but convey vastly different messages because of differences in the intonation and stress with which the statements are uttered. This aspect of language is known as prosody. Damage to perisylvian areas in the right hemisphere can interfere with speech prosody and can lead to syndromes of aprosodia. Damage to right hemisphere regions corresponding to Wernicke s area can selectively impair decoding of speech prosody whereas damage to right hemisphere regions corresponding to Broca s area yields a greater impairment in the ability to introduce meaning-appropriate prosody into spoken language. The latter deficit is the most common type of aprosodia identified in clinical practice the patient produces grammatically correct language with accurate word choice but the statements are uttered in a monotone that interferes with the ability to convey the intended stress and affect. Patients with this type of aprosodia give the mistaken impression of being depressed or indifferent. .
