Brain Neurorehabil.  2014 Mar;7(1):61-65. 10.12786/bn.2014.7.1.61.

Mirror Writing after Thalamic Hemorrhagic Stroke: A Case Report

• Yang JK
• Park JB
• Joo SY
• Kim DY

• KMID: 1914561
• DOI: http://doi.org/10.12786/bn.2014.7.1.61

Abstract

Mirror-writing is the process of reversing individual letter and composing word sequence in opposite direction. Unintentional mirror writing has been observed in young children learning to write and interpreted as the manifestation of different cognitive impairments. It is very rare that normal right-handed adult shows mirror writing. However, the acquired "mirror writing" may be shown in left hemispheric stroke, neurodegenerative disease, and diffuse cerebral disorders. To explain this event, some assumption have been indicated such as the motor, the visual dominance, the supplementary motor area, the visio-spatial, the visual word-form, the hemispatial factor or directional and the reflected graphemic representation hypotheses. It is reported that the lesions which causes the "Mirror-writing" are the parietal lobe, basal ganglia, thalamus and right supplementary motor area, etc. We reported a case of "mirror-writing" with left thalamic hemorrhagic stroke.

Keyword

hemorrhagic stroke; mirror writing; thalamic

MeSH Terms

Adult
Basal Ganglia
Child
Functional Laterality*
Humans
Learning
Neurodegenerative Diseases
Parietal Lobe
Stroke*
Thalamus

Figure

• 

  Fig. 1 Findings of Brain magnetic resonance imaging on admission.

• 

  Fig. 2 Copying simple sentence, word, numeral figures, and symbolic letters with left hand.

• 

  Fig. 3 Drawing Clock with left hand.

Reference

1. Canzano L, Piccardi L, Bureca I, Guariglia C. Mirror writing resulting from an egocentric representation disorder: a case report. Neurocase. 2011; 17:447–460.

2. Roh JH, Koh SB, Choi YS, Yu SW, Park MK, Park KW, Lee DH. Left hand mirror writing following a left temporo-parietal lobe infarction. J Korean Neurol Assoc. 2004; 22:138–141.

3. Chia LG, Kinsbourne M. Mirror-writing and reversed repetition of digits in a right-handed patient with left basal ganglia haematoma. J Neurol Neurosurg Psychiatry. 1987; 50:786–788.

4. Gottfried JA, Sancar F, Chatterjee A. Acquired mirror writing and reading: evidence for reflected graphemic representations. Neuropsychologia. 2003; 41:96–107.

5. Lentilius R. Kühnii SGW, editor. Miscellanea medico-practica tripartita, quorum partibus prioribus continentur historiae, discursus, consilia, epistolae ab auctore ad diversos et a diversis ad ipsum exaratae... tertia autem tractatus et dissertationes virorum celeberrimorum inediti, cum sylloge medicamentorum... in praefatione exhibetur de ineunda societate iatrica consilium... cum indice... medicamentorum. Part II. Ulm: 1698. p. 586.

6. Schott GD. Mirror writing: neurological reflections on an unusual phenomenon. J Neurol Neurosurg Psychiatry. 2007; 78:5–13.

7. Paradowski W, Ginzburg M. Mirror writing and hemiplegia. Percept Mot Skills. 1971; 32:617–618.

8. Angelillo VG, Lucia ND, Trojano L, Grossi D. Persistent left unilateral mirror writing: A neuropsychological case study. Brain Lang. 2010; 114:157–163.

9. Kim HT, Song HK, Kim JH, Chung KC, Kim MH. "Mirror-writing" in the patient of intracerebral hemorrhage. J Korean Neurol Assoc. 1989; 7:150–156.

10. Chan JL, Ross ED. Left-handed mirror writing following right anterior cerebral artery infarction: evidence for nonmirror transformation of motor programs by right supplementary motor area. Neurology. 1988; 38:59–63.

11. Oblu N, Săndulescu G, Iovu C. "Mirror writing" in some neurosurgical syndromes. Discussion of 13 cases. Stud Cercet Neurol. 1967; 12:187–193.

12. Aboitiz F, Carrasco X, Schroter C, Zaidel D, Zaidel E, Lavados M. The alien hand syndrome: classification of forms reported and discussion of a new condition. Neurol Sci. 2003; 24:252–257.

13. Schott GD. Mirror writing: Allen's self observations, Lewis Carroll's "looking-glass" letters, and Leonardo da Vinci's maps. Lancet. 1999; 354:2158–2161.

14. Schott GD, Schott JM. Mirror writing, left-handedness, and leftward scripts. Arch Neurol. 2004; 61:1849–1851.

15. Ransil BJ, Schachter SC. Test-retest reliability of the edinburgh handedness inventory and global handedness preference measurements, and their correlation. Percept Mot Skills. 1994; 79:1355–1372.

16. Kim H, Oh K, Chung CS. The role of external cues in korean mirror writing. Eur Neurol. 2008; 59:85–87.

17. Kim HS, Kim YW, Park CI, Rho HJ, Park JB. Mirror-writing after corpus callosum lesion induced by both posterior cerebral artery infarction: a case report. J Korean Acad Rehabil Med. 2007; 31:351–355.

18. Fischer JP. Mirror writing of digits and (capital) letters in the typically developing child. Cortex. 2011; 47:759–762.