Finger Agnosia

In 1924, Joseph Gerstmann reported on a patient in whom an inability to select fingers of either the patient's own hand or the examiner's hand on verbal command contrasted with otherwise normal language comprehension and with correct pointing to other body parts. Gerstmann noted that the difficulties were most marked for discrimination between the second, third, and fourth fingers. He named the disturbance "finger agnosia,'' which he considered to be a partial form of autotopagnosia restricted to only the fingers. Gerstmann's patient also had difficulties with writing, calculation, and right-left discrimination. Having observed the same combination repeatedly, Gerstmann speculated that calculation was affected because children learn arithmetic by counting their fingers, writing was affected because it demands differential finger movements, and right-left discrimination was affected because it is made with reference to the hands. None of these speculations are very convincing, and later group studies indeed showed that the correlations of finger agnosia to disorders of writing, calculation, and right-left discrimination were lower than or equal to those of other neuropsychological symptoms that had not been considered as being part of the Gerstmann syndrome.

Like autotopagnosia, finger agnosia is not restricted to verbal testing. Patients also confuse fingers when asked to show on a diagram which of their fingers has been touched or to move a finger as shown on a diagram. Finger agnosia can occur in combination with autotopagnosia but also without it. Because there are cases of autotopagnosia without finger agnosia, it appears that autotopagnosia and finger agnosia represent independent disorders of body part localization. Another association has hitherto been examined only in a few patients and may turn out to be more typical: These patients had similar difficulties with selection of toes as with selection of fingers.

Adult Dyslexia

Adult Dyslexia

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