A 62 years old woman presented with acute onset confusion and bumping into th ings. On examination, she was ale, oriented with fluent speech and normal comprehension. Fuher examination revealed impaired writing (acalculia), right-left confusion, impaired arithmetic abilities, difficulty in finger identification. MRI demonstrated foci of coical and sub coical increase T2 signals and areas of leptomeningeal enhancement. Most likely diagnosis:

Answer- A (Gerstmann's syndrome)The combination of acalculia (impairment of simple arithmetic), dysgraphia (impaired writing)' finger anomia (an inability to name individual fingers such as the index and thumb), and right-teft confusion (an inability to tell whether a hand, foot, or arm of the patient or examiner is on the right or left side ofthe body) is known as Gerstmann's syndrome. When Gerstmann's syndrome is seen in isolation, it is commonly associated with damage to the inferior parietal lobule (especially the angular gyrus) in the left hemisphere.