Acalculia is a disorder that affects a person’s ability to perform basic mathematical functions, often caused by stroke, tumor, or trauma. It is distinguished from dyscalculia, a developmental disorder. Symptoms include difficulty with counting, numerical knowledge, and performing mathematical operations. Gerstmann syndrome is a cluster of neurological symptoms associated with acalculia, including agraphia, left-right confusion, and finger agnosia. Treatment depends on the severity and cause of the disorder, and rehabilitation programs have shown improvement in math skills.
Acalculia is a term derived from the Greek letter A, which means “not”, and from the Latin word calculare, which means “to count”. The phrase describes an acquired disorder that affects a person’s ability to perform basic mathematical functions. This disorder is usually caused by a stroke, tumor or trauma and is often associated with dementia. Dyscalculia is a similar disorder affecting math skills, but is distinguished from acalculia in that it is a developmental disorder that impairs the acquisition of math skills during the childhood years.
The specific complaints in patients with acalculia vary to some extent, but several major symptoms are usually present. Patients will often have difficulty counting back and forth and will lack basic numerical knowledge, such as how many weeks there are in a year. There will often be considerable difficulty transcribing between numbers written in word form and numbers written in number form, reading and writing numbers of varying levels of complexity, and comparing the size of two numbers to determine which is larger or smaller. The greatest difficulty can be observed in performing mathematical operations and patients may not be able to interpret simple mathematical signs. Patients may also show an inability to line up numbers in columns.
This disorder is occasionally detected in its primary form, which is a basic defect in computational ability, but is most frequently encountered as a cluster of neurological symptoms which are collectively referred to as Gerstmann syndrome. In addition to acalculia, the main symptoms of Gerstmann syndrome include an inability to express yourself verbally, called agraphia; right-to-left identification problems, called left-right confusion; and difficulty distinguishing between fingers on one’s hand and/or an inability to detect which finger a tactile stimulus was applied to in the absence of a visual cue, called finger agnosia. Gerstmann syndrome is usually associated with damage to the angular gyrus of the left parietal lobe of the brain, which can result from bleeding during a stroke or head injury, viral encephalitis, a tumor, or exposure to toxins.
The prognosis for acalculia varies depending on several factors, including the severity of symptoms and the cause of the disorder. Treatment is often aimed at curing the condition that started the disorder, such as stroke or viral infections; both acalculia and other symptoms associated with Gerstmann syndrome may therefore decrease as treatment progresses. Recovery related to primary acalculia is usually limited and is instead aimed at symptom management. A long-term rehabilitation program that includes multiple activities ranging from fairly simple, such as counting real objects, to more complex activities, such as using math operations, has shown an overall improvement in the affected patients’ math skills.
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