Apraxia

Definition

Apraxia is being unable to perform tasks or movements you've already learned, even though your muscles and senses work properly. It is a disorder of the nervous system.

Alternative Names

Inability to make gestures and perform certain tasks; Movements - inability to perform certain tasks; Buccofacial apraxia; Orofacial apraxia; Ideational apraxia; Ideomotor apraxia; Limb-kinetic apraxia; Verbal apraxia

Considerations

There are many different forms of apraxia. Some are listed below:

• Buccofacial or orofacial apraxia: You have difficulty carrying out movements of the face on demand. For example, you may not be able to lick your lips or whistle.
• Ideational apraxia: You can no longer carry out learned complex tasks in the proper order, such as putting on socks before putting on shoes.
• Ideomotor apraxia: You can no longer voluntarily perform a learned task when given the necessary objects. For instance, if given a screwdriver, you may try to write with it as if it were a pen. Or, you might try to comb your hair with a toothbrush.
• Limb-kinetic apraxia: You have difficulty making precise movements with an arm or leg.
• Verbal apraxia: You have trouble coordinating mouth movements and speech.

Other conditions contain the term "apraxia," but they are not officially a form of the condition. These "apraxia-like syndromes" include:

• Dressing apraxia (difficulty buttoning a shirt or tying a shoelace)
• Gait apraxia (difficulty starting to walk)
• Lid-opening apraxia (difficulty opening the eyelids)

Apraxia may occur with a language disorder called aphasia.

OUTLOOK

Many people with apraxia are no longer able to be independent. They should avoid activities in which they might injure themselves or others.

Occupational therapy and counseling may help both patients and their caregivers learn ways to deal with the apraxia. However, because people with apraxia have trouble following instructions, occupational therapy for stroke or other brain injury is difficult.

No drug has been shown useful for treating apraxia.

Common Causes

• Brain tumor
• Dementia
• Hemodialysis (long-term)
• Condition that causes the nervous system to deteriorate (neurodegenerative illness)
• Stroke

Home Care

Take the proper safety measures if you have:

• Confusion
• Seizures
• Problems with your senses
• Weakness

However, you can still participate in normal activities.

You must have extreme patience with people who have apraxia. Take time to show them how to do the task and allow enough time for them to perform the task. Avoid giving complex directions.

Call your health care provider if

Call your health care provider if you are unable to do simple, routine acts and there is no known reason.

What to expect at your health care provider's office

If you are having seizures, you will be stabilized first.

The doctor will perform a physical exam and ask you questions about your medical history and symptoms, including:

• Are you on dialysis for chronic kidney failure?
• What other symptoms do you have? For example, do you have:
  • Confusion or disorientation
  • Memory loss
  • Numbness or tingling of any body part
  • Seizures
  • Weakness or paralysis of any body part

Tests that may be done include:

• Blood tests
• Cranial CT scan
• Lumbar puncture
• MRI of the head
• X-ray

Your doctor may refer to you a physical, speech, or occupational therapist. If the movement problem is a symptom of another medical condition, that condition should also be treated.

References

Heilman KM, Watson RT, Gonzalez-Rothi LJ. Praxis. In: Goetz CG. Textbook of Clinical Neurology. 3rd ed. Philadelphia, PA: Saunders Elsevier; 2007:chap 4.