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[Bimanual mirror letter writing: a post-traumatic case].

Mirror writing is inverse writing that can only be read with the help of a mirror. It is generally associated with dominant hemisphere lesions and affects only one hand. We describe the case of a patient who, after cranial injury, developed bimanual mirror writing for letters but no other focal neurological symptom. The only abnormal complementary finding was a zone of left parieto-occipital hypoperfusion visibly by SPECT. No signs of psychological disorder were present to which the dysgraphia could be attributed. Symptoms disappeared after three months. We conclude that isolated bimanual mirror letter writing may be an expression of reversible parieto-occipital dysfunction of the dominant hemisphere.

Adolescent↗

[Number agraphia].

One hundred and seventy-five aphasic patients (50 total, 50 mixed, 50 motor-amnesic and 25 sensory-amnesic aphasics) were tested for the writing to dictation of numbers with more than one digit. Twelve types of error were found. The percentages for the different types of error were determined for all subtypes of aphasic patients and for the total group of patients. In 98% of the aphasic subjects at least one or several types of error were ascertained. In all, 80.6% of the patients were unable to write correctly a number of three digits. Certain types of disturbances, such as macrographia, serial writing, perseveration and mirror writing, occurred more often when numbers were dictated than when words or letters were dictated. In the patients with sensory-amnesic aphasia these disturbances were found more often than in those with motor-amnesic aphasia. With respect to German-speaking patients, a particular type of error concerns the serial ordering of numbers with more than one digit (Stellenwertfehler). This type of error was found in 34.9% of our patients. Our results suggest standard examinations of aphasic patients should include the writing to dictation of numbers with more than one digit.

Agraphia↗

Some neurological observations on Leonardo da Vinci's handwriting.

The present study concerns neuropsychological aspects of the handwriting of Leonardo da Vinci. The evidence for Leonardo's left handedness is considered, and a critical appraisal of his mirror writing and its underlying mechanism is presented. The relationship between Leonardo's sinistrality, mirror writing and certain aspects of localisation of cerebral function are discussed. From these considerations and from new evidence obtained from contemporary historical sources, it is proposed that Leonardo's language skills were lateralised to the more unusual right hemisphere.

Art↗

A second Leonardo da Vinci?

We describe a young woman who suddenly began mirror writing with her right hand and has not reverted to normal writing for more than 6 years, although she writes normally with her left hand. She is ambidextrous, although she had previously used only her right hand for writing and drawing. Since it is much easier for her to use right-handed mirror writing, she uses her left hand only for writing meant to be read by others and her right hand for all other writing. Her hobbies are sculpture and painting, and her chief complaint is migraine accompanied by sensory and perceptive disturbances.

Adult↗

Object reversals after parietal lobe infarction--a case report.

A case is described of a mixed manually dominant man with a right parietal infarction who demonstrated reversals in object manipulation. Although mirror reversals in parietal lobe dysfunction and right-left spatial reversal in conjunction with mirror writing have been reported previously, object and spatial reversal to this extent has not been reported. The theoretical implications of the absence of mirror writing here, in relation to side of brain lesion and handedness, are discussed.

Aged↗

Mirror-reading and writing in association with right-left spatial disorientation.

A left-handed patient suddenly developed a right hemiparesis, mirror-reading, and mirror-writing. Although he could discriminate between right and left on himself, he demonstrated right/left spatial disorientation. We propose that his right/left spatial disorientation was induced by a scanning defect. It has been demonstrated that mirror-image engrams are normally available. We believe that a reversal of the learned left-to-right scanning process with the availability of mirror engrams induced mirror-reading. Similarly, reversal of the normal left-to-right writing pattern, with the availability of mirror engrams, induced mirror-writing.

Dominance, Cerebral↗

[Clinical features of neuroses in left-handed children].

A study covering 100 sinistral and 100 dextral neurotic children revealed a higher percentage of persons with manifestations of motor disinhibition, phobias and anxiety among sinistral children. It was also in this group that a considerable number of children presented at the beginning of schooling such phenomena as "mirror" writing and attempts of reading and counting from right to left. Elements of "mirror" thinking seemed to explain difficulties in learning writing and reading observed in such children. The authors discuss the questions of prophylactic measures in sinistral children with neuroses.

Adolescent↗

Looking with one's mind's eye.

On the basis of clinical cases reported in the literature, an attempt is made to show that conscious mental representations of written words have a left-right dimension similar to their counterparts in the physical world. They may, therefore, be affected by unilateral neglect in much the same way as words on a written or printed page. Usually, real words and their representations run in the same direction. However, in some cases, they appear to run in opposite directions and this may result in the production of mirror writing.

Aged↗

[Mirror phenomena in patients with different autoimmune disorders].

The aim of the article was to study functional asymmetry between hemispheres and to find an ability to mirror phenomena in 25 patients with systemic lupus erythematosus (SLE) and 12 patients with multiple sclerosis. Patients with SLE had the following individual profiles of functional asymmetry: right, mainly right, mixed and mainly left. Nobody of them had either symmetric or left profiles. An ability to mirror phenomena (mirror drawing and mirror writing) has been found in 56% of SLE patients with different individual profiles of functional asymmetry. These patients significantly differed from the control group and patients with multiple sclerosis.

Adult↗

[Mirror reading and writing].

The case of a left handed patient, a woman 59 years old, who some days after the onset of a right hemiplegia with slight motoric and sensoric aphasic disorders, presented reverse (en miroir) reading and writing is described. Difficulties in the recognition of the right and left side could be revealed during the examination. No hemianopia was noted but an "unwillingness" to turn the eyes to the right side, without paresis, was noted. This could be, in relation with the disorder of the orientation in the space and the reanimation of primitive phasic functions, the basic mechanism that explains the above described symptom of reverse reading and writing.

Aphasia↗

Mirror movements of the left arm following peripheral damage to the preferred right arm.

Cerebral damage which renders the preferred arm useless may lead patients to use their non-preferred arm for everyday tasks including writing. In these circumstances, mirror writing and other mirror movements may occur. The present study on 10 formerly right-handed patients was carried out to determine whether similar phenomena occurred when serious damage to the right arm itself had occurred, cerebral function remaining intact or any damage being coincidental and non-focal. The patients were asked to describe the events that had occurred when they started using their left hand, to carry out a number of writing tests, and to undertake two graphic tasks to assess directional motor preferences. Seven patients had executed mirror reversal of letters, and eight had experienced mirror phenomena when carrying out everyday tasks with their left hand; brief case histories are cited. No patient exhibited mirror writing on formal testing, and there was no evidence of alteration in the expected preference of direction in which graphic tasks were undertaken. The practical and theoretical implications of these observations are discussed.

Adult↗