PeBenito R, Fisch C B, Fisch M L
Stanley S. Lamm Institute for Child Neurology and Developmental Medicine, Long Island College Hospital, Brooklyn, NY 11201.
Arch Neurol. 1988 Sep;45(9):977-82. doi: 10.1001/archneur.1988.00520330063011.
The tetrad of finger agnosia, dysgraphia, dyscalculia, and right-left disorientation make up Gerstmann's syndrome. The tetrad has been infrequently described in children with learning disability and has been called developmental Gerstmann's syndrome (DGS). Developmental Gerstmann's syndrome may occur in brain-damaged and apparently normal children. Five children in whom DGS occurred in association with brain abnormalities underwent long-term observation, which indicated persistence of the deficits. The identification of these cases suggests that DGS may not be as rare as previously thought and may often be unrecognized. Testing for the Gerstmann elements in learning-disabled children may identify otherwise undiagnosed cases of DGS and should be routinely employed in the neurologic examination. Until appropriate teaching methods for DGS are found, "bypassing" the deficits and utilizing the child's strengths, plus counseling, seem to offer an effective treatment approach.
手指失认、书写障碍、计算障碍和左右定向障碍这四联征构成了格斯特曼综合征。这种四联征在学习障碍儿童中鲜有描述，被称为发育性格斯特曼综合征（DGS）。发育性格斯特曼综合征可能发生在脑损伤儿童和看似正常的儿童中。对5例伴有脑异常的发育性格斯特曼综合征患儿进行了长期观察，结果表明这些缺陷持续存在。这些病例的发现表明，发育性格斯特曼综合征可能不像以前认为的那么罕见，而且可能常常未被识别。对学习障碍儿童进行格斯特曼综合征相关要素的检测，可能会发现其他未被诊断出的发育性格斯特曼综合征病例，因此在神经科检查中应常规进行此项检测。在找到针对发育性格斯特曼综合征的合适教学方法之前，“绕过”这些缺陷并利用患儿的优势，再加上咨询，似乎是一种有效的治疗方法。
