Persisting Reversed Clock Syndrome

BACKGROUND The reversed clock phenomenon results in the transposition of objects from one side to another. Its major manifestation consists in the reversal of clock numbers in clock-drawing test. It could be due to a stroke disrupting attentional cerebral network. This phenomenon usually regresses in a few days. OBJECTIVE To report a case of reversed clock phenomenon with disorders of space representation that did not regress spontaneously. DESIGN Case report. PATIENT A 67 year-old woman was referred due to headaches associated with gait disorder, visual field deficit and disturbance of space representation. RESULTS Magnetic resonance imaging demonstrates two right cerebral infarcts mainly localized in the parieto-occipital region. A week after her stoke, clinical testing confirms a reversed clock phenomenon. The patient placed the hands of a clock in the opposite direction of what was specified. She got lost at home locating rooms in directions opposite to their real ones. Rehabilitation sessions partially improved these manifestations. CONCLUSION Although it usually improves in a few days, reversed clock phenomenon can persist longer. Rehabilitation sessions based on localization exercises may be helpful in such situations.