Persistent left unilateral mirror writing: A neuropsychological case study

Valentina G. Angelillo, Natascia De Lucia, Luigi Trojano, Dario Grossi

Research output: Contribution to journalArticlepeer-review


Mirror writing (MW) is a rare disorder in which a script runs in direction opposite to normal and individual letters are reversed. The disorder generally occurs after left-hemisphere lesions, is transient and is observed on the left hand, whereas usually motor impairments prevent assessment of direction of right handwriting. We describe a left-handed patient with complete left hand mirror writing, still evident 2 years after a hemorrhagic stroke in left nucleo-capsular region. Since the patient could write with his right hand he underwent several writing tasks with either hand, and a thorough assessment to clarify the nature of MW. MW was evident in writing to dictation with left hand only, both in right and left hemispace, but the patient could modify his behavior when a verbal instruction was provided. No mirror errors were found in reading words, in copying geometric figures and in spatial orientation tasks. MW in our patient could be accounted for by a failure in automatic transformation of grapho-motor programs to write with the left hand. A lack of concern (a sort of anosodiaphoria) and a poor cognitive flexibility could contribute to long-term persistence of MW.

Original languageEnglish
Pages (from-to)157-163
Number of pages7
JournalBrain and Language
Issue number3
Publication statusPublished - Sep 2010


  • Grapho-motor processes
  • Mirror writing
  • Subcortical lesion

ASJC Scopus subject areas

  • Linguistics and Language
  • Speech and Hearing
  • Experimental and Cognitive Psychology
  • Cognitive Neuroscience
  • Medicine(all)


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