DISCUSSION
Patients with dominant-sided paresis due to a stroke to the
corresponding hemisphere may rarely show spontaneous and unconscious
mirror writing during the initial attempts to write with their
non-dominant hand. The non-dominant cerebral hemisphere attempts to
imitate the necessary arm movements based on the motor memory forged
during the writing-learning process, and these movements are reversed.
The literature on the pathophysiology of mirror writing reveals a lack
of knowledge of the process. Various hypotheses have been proposed,
including alterations of the motor cortex, spatial orientation, and
visual and thalamocortical circuits.3 In this case,
during the postictal period, the left cerebral hemisphere was affected
by the seizures, and consecutive epileptiform discharges and
disinhibition of the right cerebral hemisphere could have occurred,
which may explain the observed behavior.