Gerstmann syndrome comprises which four core features?

• A. Acalculia, finger agnosia, left-right disorientation, agraphia
• B. Acalculia, finger agnosia, color agnosia, acromegaly
• C. Numeracy deficits, alexia, neglect, apraxia
• D. Language deficits only

Answer: (A)

Gerstmann syndrome is defined by four deficits that reflect disruption in the dominant parietal cortex, especially the angular gyrus. The four deficits are acalculia (difficulty with numbers), finger agnosia (difficulty identifying or naming fingers), left–right disorientation (difficulty telling left from right on the body or in space), and agraphia (difficulty writing).

These symptoms cluster because they rely on integrating sensory input with language and numerical processing. When the dominant inferior parietal lobule is damaged, the brain’s ability to map symbols (numbers, letters) to their meanings and to coordinate body-related spatial information becomes disrupted, leading to this characteristic quartet.

Other listed options don’t fit the same pattern. Color agnosia is a visual recognition impairment, acromegaly is an endocrine disorder, and a mix of numeracy deficits with alexia and neglect points to different syndromes. Language deficits alone are too nonspecific to capture the distinctive four-part presentation of Gerstmann syndrome.