Fluent aphasia with Gerstmann's syndrome: A case study

A right-handed 67-year-old man presented with moderate expressive and receptive aphasia secondary to a left cerebrovascular accident which was sustained following surgery for an artery bypass graft. In addition to the aphasia this patient also exhibited the tetrad of symptoms associated with Gerstmann's syndrome. The clinical presentation of the syndrome consisted of right/left disorientation, finger agnosia, acalculia, and agraphia. The pattern of recovery for these symptoms and other language behaviours during treatment and no-treatment periods revealed that traditional aphasia treatment methods appear to aid all symptoms but the agraphia. Our findings suggest that traditional aphasia treatment methods may stimulate resolution of coexisting neurological symptoms in Gerstmann's syndrome, and that differential diagnosis is of paramount importance. Additionally, we point towards the need for further research of neurological syndromes coexisting with aphasia and treatment methods that respond to the unique characteristics of syndromes.