Apraxia is basically a cognitive motor disorder in which the patient’s ability to perform learned, skilled actions correctly is affected. This failure to execute skills does not arise from an impaired motor power, co-ordination or sensation. So although the patient has both the want and physical ability to perform the action and can even verbally describe its rationale, he is simply unable to competently execute it. Apraxia should not be mixed up with aphasia (disturbance of spoken & written language); although, they do occur commonly together.
What is the cause of apraxia ?
Apraxia is mostly due to a lesion located in the dominant (usually left) hemisphere of the brain, classically in the frontal and parietal lobes. Lesions can be either due to stroke, acquired brain injuries, or neurodegenerative diseases like Alzheimer’s disease & other dementias. Apraxia is a hallmark of some of the diseases of basal ganglia, such as Parkinson’s disease, Progressive Supranuclear Palsy (PSP) and Huntington’s disease.
The ideomotor type of apraxia is commonly seen in patients with corticobasal degeneration. Corticobasal degeneration is the disorder most commonly associated with apraxia. Corticobasal degeneration (CBD) is an uncommon, progressive neurodegenerative disease affecting both the cerebral cortex and the basal ganglia. In fact, apraxia is a hallmark of corticobasal degeneration and is a significant component of all proposed diagnostic criteria.
What are the types of apraxia ?
- Ideomotor apraxia: These patients are unable to plan or complete motor actions that rely on logical memory. They will be able to explain exactly how to perform an action, but will be unable to act out that movement when asked to do so. However, they can perform an action automatically, without thinking twice about it. This is what is known as automatic-voluntary dissociation. For instance, they may be unable to pick up a phone when instructed, but they can perform the action without even thinking as the phone rings.
- Ideational/conceptual apraxia: Patients are not able to conceptualize a task and do the multistep actions. If a motor program is to be done, the patient will do it, but in a disorderly sequence. For instance, they may butter bread before putting it in the toaster, or put on shoes before putting on their socks.
Secondly, there can also be a loss of ability to willingly perform a learned task when given the required objects or tools. For example, they may use a screwdriver to write or comb hair with a toothbrush. - Buccofacial or orofacial apraxia: This is difficulty in carrying out face movements, on demand. For instance, the patient may have an inability to lick one’s lips, whistle or blow the cheeks.
- Constructional apraxia: The inability to draw or construct simple configurations, such as intersecting shapes.
- Gait apraxia: The inability of the lower limbs to conduct normal functions like walking. Again, this is not due to loss of either motor or sensory functions.
- Limb-kinetic apraxia: Voluntary movements of extremities like waving and writing are impaired.
- Oculomotor apraxia: There is a difficulty in moving the eye, especially while looking at targets.
- Apraxia of speech (AOS): Difficulty in planning and coordinating the oral movements necessary for speech (For instance, potato will be pronounced as totapo or topato.)
How is apraxia diagnosed ?
- The qualitative and quantitative assessment of gestures helps to diagnose apraxia. Gestures like “put your index finger at the tip of your nose”, “wave goodbye” and “show me how to use a hammer” gestures should be assessed.
- A complete assessment of apraxia has to include formal testing, observation of casual daily routines, both questionnaires and targeted interviews with the patients and their relatives.
What is the treatment of apraxia?
The treatment for apraxic individuals include-1) Speech therapy2) Occupational therapy &3) Physical therapy. This form of combined rehabilitative treatment has been found to positively impact apraxia as well as daily living.
How to find neurologists for apraxia treatment ?
Now you can find neurologists for apraxia treatment from different hospitals and destinations on a single platform, Hinfoways. You can avail opinions from multiple neurologists, get cost estimates for apraxia treatment from different hospitals, compare things and then choose a neurologist for apraxia treatment.
Find a neurologist for apraxia treatment on Hinfoways. Make an informed choice.
Disclaimer: The content provided here is meant for general informational purposes only and hence SHOULD NOT be relied upon as a substitute for sound professional medical advice, care or evaluation by a qualified doctor/physician or other relevantly qualified healthcare provider.
