To the Editor.
—We read with interest the recent article by PeBenito et al1 of several cases of developmental Grestmann's syndrome. We were concerned that mention was not made of fragile X syndrome as a possible cause. The validity of Gerstmann's syndrome,2,3 which is comprised of dysgraphia, dyscalculia, finger agnosia, and right-left disorientation, has been the subject of considerable debate.4-10 The same has been true of the developmental Gerstmann syndrome (DGS), which also includes deficits in constructional praxis.11,12PeBenito et al reported on five children who had all five signs of the developmental Gerstmann disorder, as well as various combinations of motor and attentional problems. Four of the five had at least average reading ability. In their discussion, the authors state that "the etiology of DGS is unknown. Whereas some specific learning disorders (eg, dyslexia) have a familial tendency, this is not observed in DGS" (p
Grigsby J, Hagerman R. Fragile X Syndrome: A Genetic Etiology for Developmental Gerstmann's Syndrome. Arch Neurol. 1989;46(12):1269–1270. doi:10.1001/archneur.1989.00520480011005
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