Spontaneous opening and closing of both eyes usually occurs in the normal awake state, unless a deliberate and voluntary attempt is made to open only one eye. We present a rare case of a male patient who was unable to open both eyes simultaneously after bilateral posterior cerebral artery infarction. He was able to close both eyes voluntarily. However, he was unable to keep both eyes open simultaneously and either the right or left eye remained closed. Upon a verbal command to open both eyes, the opened eye closed and the contralateral eye opened. When the closed eye was forced open, the opened eye closed. We thus presented a case of right-left dissociation of voluntary eyelid opening following bilateral posterior cerebral artery infarction, which was treated with botulinum toxin type A injection. Differential diagnosis to other movement disorders of the eyelids was discussed.
“Mirror-writing” is the simultaneous process of reversing individual letters and composing word strings in reverse direction. It is reported that the lesions which cause “mirror-writing” are left parietal lobe, left basal ganglia, right supplementary motor area, left supplementary motor area, left cingulate gyrus, and left angular gyrus. To explain this phenomenon, several theories have been proposed such as the motor, the visual dominance, the supplementary motor area, the visio-spatial, the visual word- form, the hemisaptial factor or directional and the reflected graphemic representation hypotheses. With reviewing some of literatures, we present a case of “mirror- writing” of posterior corpus callosum lesion which is not included in the aforementioned those. (J Korean Acad Rehab Med 2007; 31: 351-355)