J Neurol Neurosurg Psychiatry 63:399-403 doi:10.1136/jnnp.63.3.399
  • Short report

Toe agnosia in Gerstmann syndrome

  1. Oliver Tuchaa,
  2. Anne Steupa,
  3. Christian Smelyb,
  4. Klaus W Langea
  1. aDepartment of Neuropsychology, bDepartment of Neurosurgery, University of Freiburg, Freiburg, Germany
  1. Professor KW Lange, Institute of Psychology, University of Freiburg, 79085 Freiburg, Germany
  • Received 8 January 1997
  • Revised 20 March 1997
  • Accepted 3 April 1997


The following case report presents a patient exhibiting Gerstmann syndrome accompanied by toe agnosia. A 72 year old right handed woman had a focal lesion in the angular gyrus of the left hemisphere which was caused by a glioblastoma multiforme. The first symptom she had complained of was severe headache. Standardised neuropsychological tests of intelligence, memory, attention, fluency, apraxia, and language functions as well as tests for the assessment of agraphia, acalculia, right-left disorientation, and digit agnosia were performed. The patient displayed all four symptoms of the Gerstmann syndrome—namely, agraphia, acalculia, right-left disorientation, and finger agnosia. The patient did not display aphasia, constructional apraxia, or any other neuropsychological impairment. In addition to the four symptoms of the Gerstmann syndrome an agnosia of the toes was found. Further studies should determine whether finger agnosia in Gerstmann syndrome is usually accompanied by toe agnosia. Finger agnosia in the context of this syndrome may be better named digit agnosia.


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