Apraxia

Apraxia is the inability to carry out familiar, purposeful movements, where the cause is something other than paralysis or other sensory or motor impairments. Apraxia is derived from Greek words meaning "not acting" and is distinguished from the more mild form called dyspraxia.

Types

• Amnestic apraxia is the inability to remember how to carry out a movement
• Buccofacial or orofacial apraxia is the inability to carry out facial movements on command such as licking lips, whistling, coughing, or winking
• Cogan's oculomotor apraxia is the inability to move the eyes left or right
• Constructional apraxia is the inability to copy simple drawings or reproduce patterns created with simple objects
• Dressing apraxia is the inability to dress oneself
• Ideomotor apraxia is the inability to make the proper movement in response to a verbal command
• Ideational apraxia is the inability to coordinate activities with multiple, sequential movements, such as dressing, eating, and bathing
• Verbal apraxia is difficulty coordinating mouth and speech movements
• Limb-kinetic apraxia is the inability to make fine, precise movements with an arm or leg
• Sensory apraxia is the inability to make proper use of an object due to lack of understanding of the object's nature and purpose

Causes

Apraxia results from dysfunction of the cerebral hemispheres of the brain, especially the parietal lobe, and can arise from many diseases or damage to the brain. Stroke (brain injury caused by interruption of blood flow) is one of the leading causes of apraxia.

Diagnosis

Diagnosis of apraxia is usually straightforward and based on patient or caregiver reports and/or observations made during the neurological portion of a complete physical exam. A relatively new diagnostic tool, the Brief Neuropsychological Screening (BNS), can detect either the presence or absence of damage in different cognitive areas, with particular emphasis to those most frequently occurring after a stroke, such as aphasia, apraxia, or agnosia ^[1]. Where the diagnosis is uncertain, physicians may need to use more invasive imaging or physiological tests to guide therapeutic decisions.

Treatment

Generally, treatment for individuals with apraxia includes physical, speech, or occupational therapy. If apraxia is a symptom of another disorder, the underlying disorder should be treated.

Prognosis

The prognosis for individuals with apraxia varies and depends partly on the underlying cause. Some individuals improve significantly while others may show very little improvement.

Research

Several promising lines of research exist for cognition, behavior, and mood disorders, In particular, combinations of the essential nutrients docosahexanoic acid (DHA) and eicosapentaenoic acid (EPA) may benefit patients. ^[2]. Other prescription medicines such as diazepam and piracetam ^[3] may help manage associated symptoms.

References

1. ↑ Lunardelli A, Mengotti P, Pesavento A, Sverzut A, Zadini A. The Brief Neuropsychological Screening (BNS): valuation of its clinical validity. Eur J Phys Rehabil Med 2009 45(1): 85-91. Abstract | PDF
2. ↑ Kidd PM. Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids. Altern Med Rev 2007 Sep; 12:207. Abstract | |PDF
3. ↑ Jordan LC, Hillis AE. Disorders of speech and language: aphasia, apraxia, and dysarthria. Curr Opin Neurol 2006 19:580. Abstract