A Case of Upside-down Writing and Upside-down Drawing

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  • Hara Yuki
    Department of Rehabilitation, Gyokushokai Kajikionsen Hospital.
  • Etoh Seiji
    Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University

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  • 倒立書字・倒立描画を呈した一症例

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<p>  This study reports a case of upside-down writing and upside-down drawing caused by cerebral infarction of the left middle cerebral artery territory. The patient was able to perceive the morphology of letters, objects and images, but had difficulty perceiving their orientation. Moreover, he showed difficulty in discriminating between upright and upside-down letters and object drawings. The patient was able to identify the top or bottom of drawings of an object, but was unable to identify the top or bottom of letters. These difficulties of spatial orientation, which were similar to those found in orientation agnosia, lasted more than 6 months after onset. The patient underwent training in spatial orientation of letters and objects with use of external cues for 10 months, and thereafter his upside-down letters and object drawings disappeared. We discussed this patientʼs difficulties of spatial orientation for letters and objects on the basis of object-centered coordinates and observer-centered coordinates. We believe that upside-down writing and upside-down drawing in this case may have resulted from motor execution based on impaired mental representation of spatial coordinates.</p>

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