• Apraxia

    (Buccofacial Apraxia; Conceptual Apraxia; Constructional Apraxia; Gait Apraxia; Ideomotor Apraxia; Limb-Kinetic Apraxia; Movement Disorder; Orofacial Apraxia; Stroke Complications)

    Definition

    Apraxia happens when you are unable to do learned movements or signals. You may have the desire and the physical ability to do the movements, but you cannot. There are many types of apraxia.
    Stroke
    si1213 97870 1 Ischemic Stroke.jpg
    Stroke can cause brain damage, which can lead to apraxia.
    Copyright © Nucleus Medical Media, Inc.

    Causes

    Apraxia is caused by diseases or damage in the brain, such as:
    • Stroke
    • Brain tumor
    • Brain injury
    • Infection
    • Brain disease, such as:

    Risk Factors

    Apraxia may be due to stroke. It is important to know the risk factors for stroke such as:

    Symptoms

    Some of the common forms of apraxia and some of their symptoms include:
    • Buccofacial or orofacial apraxia (common)—inability to make facial movements, such as winking, whistling, or sticking out tongue
    • Constructional apraxia—inability to copy or draw simple figures or to make two- or three-dimensional forms
    • Gait apraxia—difficulty walking, which can lead to an increased risk of falls
    • Conceptual apraxia—inability to select or use tools or objects properly, inability to make complex movements at the same time and to do tasks in order
    • Limb-kinetic apraxia—inability to make fine, exact movements with hands or fingers (eg, handling coins)
    • Ideomotor apraxia—inability to copy movements or make signals, inability to do a function on command
    • Dressing apraxia—inability to dress oneself

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:
      A neurological exam—You may be asked to:
      • Copy posture, movement, sequences
      • Draw shapes
      • Put together designs
      • Pick up or rotate coins
      • Select a tool (eg, a hammer) and demonstrate how to use it
      • Arrange movements in sequence
    • Exam of muscles used in speech
    • Evaluation of walking skills
    • Your doctor may need pictures of your brain. This can be done with:
    If you are diagnosed with apraxia, you could also have aphasia . Aphasia is a language disorder.

    Treatment

    Your treatment depends on what kind of apraxia you have. Families should ask about individualized treatment programs such as:
    • Physical therapy
    • Occupational therapy
    • Speech therapy
    • Cognitive rehabilitation
    It is also important to treat the cause of the apraxia.

    Home Care

    If you are living with someone who has apraxia, these healthcare providers can offer support:
    • Discharge planner—to help arrange care, such as long-term care or outpatient treatment
    • Social worker—to help identify resources for families and patients
    • Mental health worker —to help families cope

    Prevention

    It may be difficult to prevent this condition. It is strongly linked to stroke. Following steps to prevent stroke may help. Some of these steps include:

    RESOURCES

    American Speech-Language-Hearing Association http://www.asha.org

    National Institute of Neurological Disorders and Stroke http://www.ninds.nih.gov/

    CANADIAN RESOURCES

    Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca

    Health Canada http://www.hc-sc.gc.ca

    References

    Apraxia, constructional. EBSCO Publishing Nursing Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/nrc-about . Updated June 22, 2012. Accessed November 26, 2012.

    Apraxia, gait. EBSCO Publishing Nursing Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/nrc-about . Updated May 27, 2011. Accessed November 26, 2012.

    Apraxia, ideational. EBSCO Publishing Nursing Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/nrc-about .Updated September 2, 2011. Accessed November 26, 2012.

    Apraxia, ideomotor. EBSCO Publishing Nursing Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/nrc-about . Updated August 17, 2012. Accessed November 26, 2012.

    Apraxia in adults. American Speech-Language-Hearing Association website. Available at: http://www.asha.org/public/speech/disorders/ApraxiaAdults.htm . Accessed November 26, 2012.

    Apraxia, limb-kinetic. EBSCO Publishing Nursing Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/nrc-about . Updated August 3, 2012. Accessed November 26, 2012.

    Childhood apraxia of speech. American Speech-Language-Hearing Association website. Available at: http://www.asha.org/public/speech/disorders/ChildhoodApraxia.htm . Accessed November 26, 2012.

    Curioni C, André C, Veras R. Weight reduction for primary prevention of stroke in adults with overweight or obesity. Cochrane Database of Systematic Reviews [serial online]. 2006;4. Available at: http://www.cochrane.org/reviews/en/ab006062.html . Accessed November 26, 2012.

    Heilman KM, Valenstein E, Rothi LJG, Watson RT. Upper limb action-intentional and cognitive-apraxic motor disorders. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice . 5th ed. Philadelphia, PA: Butterworth Heniemann Elsevier; 2008; 121-132.

    Lukas RV. Two automobile collisions in one day. J Emerg Med. 2012;43(4):e263-4.

    NINDS apraxia information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/apraxia/apraxia.htm . Updated October 1, 2010. Accessed November 26, 2012.

    NINDS frontotemporal dementia information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/picks/picks.htm . Updated May 16, 2012. Accessed November 26, 2012.

    Stroke complications: perceptual disorders—apraxia and agnosia. EBSCO Publishing Nursing Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/nrc-about . Updated September 23, 2011. Accessed November 26, 2012.

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