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 gestures. You may have the desire and the physical ability to do the movements, but you cannot. This is usually due to brain damage, such as a stroke or a brain tumor. There are many types of apraxia. If you have this condition, you may also have aphasia. Aphasia is a language disorder.
Stroke
Causes
Apraxia is caused by diseases or damage to the cerebral hemispheres in the brain, such as:
- Stroke
- Brain tumor
- Trauma to brain
- Infection
-
Degenerative brain disease, such as:
- Alzheimer’s disease
- Frontotemporal dementia (a syndrome associated with shrinking of the frontal and temporal anterior lobes of the brain)
- Huntington’s disease
- Corticobasal ganglionic degeneration (CBD)
Risk Factors
Since this condition may be due to stroke, it is important to know the risk factors for stroke, such as:
- Age: 60 or older
- Prior stroke or cardiovascular disease
- Prior transient ischemic attack (TIA)
- High blood pressure
- High cholesterol
- Diabetes
- Smoking
- Dialysis (treatment that takes over the job of the kidneys when they fail)
Talk to your doctor if you have any of these risk factors.
Symptoms
The following is a list of some of the common forms of apraxia and their symptoms:
- 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 construct two- or three-dimensional forms
- Gait apraxia—marked by shuffling steps, stooped posture, halting steps, inability to step over obstacles
- Conceptual apraxia—inability to select or use tools or objects properly, inability to make complex coordinated movements and to do tasks in order
- Limb-kinetic apraxia—inability to make fine precise movements with hands or fingers (eg, manipulating coins)
- Ideomotor apraxia—inability to copy movements or make gestures, inability to do a function on command
- Dressing apraxia—inability to dress oneself
Some people with apraxia have gait difficulty. This can lead to an increased risk of falls.
Diagnosis
Your doctor will ask about your symptoms and medical history. She will also do a physical exam. Tests may include:
-
Neurological evaluation to isolate deficit—You may be asked to:
- Imitate posture, movement, sequences
- Draw shapes
- Assemble designs
- Pick up or rotate coins
- Select a tool (eg, a hammer) and demonstrate how to use it
- Arrange movements in sequence
- Examination of muscles used in speech
- Assessment of walking skills
- MRI scan —a test that uses magnetic waves to make pictures of structures inside the brain
- CT scan —a type of x-ray that uses a computer to make pictures of structures inside the brain
Treatment
Your treatment depends on what kind of apraxia you have. Families should ask the doctor about individualized treatment programs, which may include:
- Physical therapy
- Occupational therapy
- Speech therapy
- Cognitive rehabilitation
Treatment of the underlying cause of the apraxia is also important.
Home Care
If you are living with someone who has apraxia, these healthcare providers can offer support:
- Discharge planner—to help arrange for continued 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. Since it is strongly linked to stroke, following steps to prevent stroke may help. Some of these steps include:
- Exercise regularly.
- Eat a healthful diet .
- Quit smoking and limit how much alcohol you drink.
- Check your blood pressure often.
American Speech-Language-Hearing Association
National Institute of Neurological Disorders and Stroke
Heart and Stroke Foundation of Canada
Health Canada
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Last reviewed February 2012 by Marjorie Bunch, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
