Apraxia Health Article

Definition

Apraxia is the inability to perform previously-learned tasks or movements even though your muscles and senses work properly. It is a neurological disorder.

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 on 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:

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

Apraxia may be accompanied by a language disorder called aphasia.

Common Causes

• Dementia
• Stroke
• Hemodialysis (prolonged)
• Neurodegenerative illness
• Brain tumor

Home Care

Safety measures should be taken to compensate for weakness, confusion, sensory deficiencies, or seizures that may accompany this problem. Participation in normal activities is encouraged.

You must have extreme patience with people who have apraxia. Take time to demonstrate tasks and allow enough time for the person to perform the task. Avoid complex directions.

Call your health care provider if

Call your health care provider if there is unexplained and persistent lack of ability to do simple, routine acts.

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:

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

Tests that may be done include:

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

Goetz, CG. Textbook of Clinical Neurology. 2nd ed. St. Louis, Mo: WB Saunders; 2003: 53-59.

Goldman L, Ausiello D. Cecil Textbook of Medicine. 22nd ed. Philadelphia, Pa: WB Saunders; 2004:2245-2246.