Kuo et al syndrome is a disease that is difficult to diagnose because it is usually associated with aphasia.15 Comprehension and fluency of speech are usually impaired. Our patient did not have aphasia, so was able to express the typical characteristics of Gerstmann’s syndrome. Thus, he was easily diagnosed. We closely observed the patient and followed his condi- tion after rehabilitation. His right-sided apraxia and right-left confusion improved significantly. His functional status and functional independence measure score also improved sig- nificantly. Supervision was needed for most activities of daily living and the functional independence measure increased from 65 to 110. He returned to normal life and work after four months of rehabilitation. He had a better prognosis and faster recovery in comparison with similar cases reported in the literature. Aggressive and intensive inpatient rehabilitation programs combined with stereotactic surgery and effective antituberculous therapy after an early diagnosis may result in a better outcome. Conclusion This report describes a rare case of an immunocompetent person suffering from a tuberculous brain abscess with subsequent Gerstmann’s syndrome and right-sided apraxia. The patient recovered and returned to normal life after antituberculous chemotherapy and rehabilitation. This case demonstrates that aggressive and intensive inpatient reha- bilitation programs combined with stereotactic surgery and effective antituberculous therapy play an important role in the management of this condition. Disclosure The authors report no conflicts of interest in this work. Dovepress References 1. Frieden TR, Sterling TR, Munsiff SS, et al. Tuberculosis. Lancet. 2003;362(9387):887–899. 2. Oncul O, Baylan O, Mutlu H, et al. Tuberculous meningitis with multiple intracranial tuberculomas mimicking neurocysticercosis clinical and radiological findings. Jpn J Infect Dis. 2005;58(6):387–389. 3. Rock RB, Olin M, Baker CA, et al. Central nervous system tuberculosis: pathogenesis and clinical aspects. Clin Microbiol Rev. 2008;21(2): 243–261. 4. Farrar DJ, Flanigan TP, Gordon NM, et al. Tuberculous brain abscess in a patient with HIV infection: case report and review. Am J Med. 1997; 102(3):297–301. 5. Velasco-Martínez JJ, Guerrero-Espejo A, Gómez-Mampaso E, et al. Tuberculous brain abscess should be considered in HIV/AIDS patients. AIDS. 1995;9(10):1197–1199. 6. Lesprit P, Zagdanski AM, de la Blanchardière A, et al. Cerebral tuber- culosis in patients with acquired immunodeficiency syndrome (AIDS). Report of 6 cases and review. Medicine. 1997;76(6):423–431. 7. Whitener DR. Tuberculous brain abscess. Report of a case and review of the literature. Arch Neurol.1978;35(3):148–155. 8. Medical Research Council. Aids to Examination of the Peripheral Nervous System. Memorandum 45. London, UK: Her Majesty’s Stationary Office; 1976. 9. Ersoy Y, Ates O, Onal C, et al. Cerebellar abscess and syringomyelia due to isoniazid-resistant mycobacterium tuberculosis. J Clin Neurosci. 2007;14(1):86–89. 10. Calfee DP, Wispeley B. Brain abscess. Semin Neurol. 2000;20(3): 353–360. 11. Gazzaz M, Bonyaakoub FA, Elkhamlichi A. Tuberculous cerebellar abscess. Acta Neurol Belg. 2000;100(1):146–147. 12. Ramesh VG, Sundar KS. Concomittant tuberculosis and pyogenic cerebellar abscess in a patient with pulmonary tuberculosis. Neurol India. 2008;56(1):91–92. 13. Mayer E, Martory MD, Pegna AJ, et al. A pure case of Gerstmann syndrome with a subangular lesion. Brain. 1999;122(Pt 6):1107–1120. 14. Carota A, Di Pietro M, Ptak R, et al. Defective spatial imagery with pure Gerstmann’s syndrome. Eur Neurol. 2004;52(1):1–6. 15. Rusconi E, Pinel P, Dehaene S, et al. The enigma of Gerstmann’s syndrome revisited: a telling tale of the vicissitudes of neuropsychology. Brain. 2010;133(Pt 2):320–332. Neuropsychiatric Disease and Treatment Publish your work in this journal Neuropsychiatric Disease and Treatment is an international, peer- reviewed journal of clinical therapeutics and pharmacology focusing on concise rapid reporting of clinical or pre-clinical studies on a range of neuropsychiatric and neurological disorders. This journal is indexed on PubMed Central, the ‘PsycINFO’ database and CAS. Submit your manuscript here: http://www.dovepress.com/neuropsychiatric-disease-and-treatment-journal 220 submit your manuscript | www.dovepress.com Dovepress Neuropsychiatric Disease and Treatment 2012:8 Dovepress The manuscript management system is completely online and includes a very quick and fair peer-review system, which is all easy to use. Visit http://www.dovepress.com/testimonials.php to read real quotes from published authors.