いわゆるゲルストマン症候群を伴った失語症3症例の臨床経過

抄録

A retrospective investigation was made on the recovery processes of three adult aphasic patients with “Gerstmann Syndrome” and other neuropsychological deficits. The period of study covered in each case was 18 months starting from one to two months post onset of illness. The major findings can be summarized as follows;
1. At the initial examination, the nature and severity of the four Gerstmann deficits (an aggregate of finger agnosia, right-left disorientation, agraphia and acalculia) varied from case to case. In addition, some other neuropsychological deficits (such as constructional apraxia, spatial disorientation and/or impairment of topographical memory and time orientation) were found in each case.
2. The prognosis of the four Gerstmann deficits differed from patient to patient. In one patient the recovery process was so good as to obtain the premorbid level, whereas in the others a fair improvement was made in finger localization, writing and calculation, but not in right-left discrimination.
3. The sites of the brain lesions confirmed by the CT scan in the three patients varied widely, i. e., bilateral and left parietal with ventricular dilatation in the first patient, left parietal in the second, and right frontal subcortical with lesion of the putamen in the third who was left handed.
On the basis of these findings, it was tentatively concluded that no specific neuropsycho-logical significance could be attached to the grouping of the four Gerstmann deficits.