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Apraxia: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Apraxia is the inability to perform purposeful, habitual motor acts for the patient, despite the absence of primary motor defects and the desire to perform this action, developing as a result of brain damage. The diagnosis is based on clinical symptoms, neuropsychological and imaging (CT, MRI) studies. The prognosis depends on the nature and extent of the lesion, as well as the patient's age. Specific treatment has not been developed, but physical therapy and occupational therapy can speed up functional recovery.
Apraxia occurs as a result of brain damage (due to infarction, tumor or trauma) or a degenerative process with the damage localized usually in the parietal lobes or related areas, where programs of actions learned during life are stored. Less often, apraxia develops due to damage to other parts of the brain (premotor cortex, corpus callosum, frontal lobe) or diffuse processes, in particular in degenerative dementias.
[ Symptoms of apraxia
The patient is unable to comprehend or perform a familiar motor task, although he or she can perform individual components of a complex movement. For example, a patient with constructive apraxia is unable to copy a simple geometric figure, despite retaining the ability to see and recognize stimuli, hold and use a pen, and understand the task. Patients are usually unaware of their disorder.
During the examination, the patient is asked to perform or repeat familiar motor acts (e.g., wave goodbye; greet; make a sign "come here", ask to go and stop; show how to open a lock with a key; show how to use a screwdriver, scissors; take a deep breath and then hold it). In parallel, the doctor checks the muscle strength in all involved muscle groups to exclude muscle weakness/paresis as the cause of the existing disorders. Neuropsychological examination, as well as information from a physiotherapist and occupational therapist, can reveal more complex variants of apraxia.
Relatives should be asked to what extent the patient is able to perform everyday activities (for example, using cutlery, a toothbrush, kitchen utensils for cooking, a hammer and scissors), and find out whether the patient can write independently.
CT or MRI (with or without angiography) can help clarify the presence and nature of a central lesion (infarction, hemorrhage, mass effect, focal atrophy). Physical examination can usually identify underlying neuromuscular diseases or injuries that may be confused with apraxia.
Prognosis and treatment of apraxia
Typically, patients become dependent, requiring assistance to perform daily activities, at least in a supervised manner. After a stroke, a stable course and even some improvement in the condition is possible.
There is no specific drug treatment. Drugs that slow the progression of dementia symptoms are ineffective against apraxia. Physical and occupational therapy may improve function somewhat, make life safer, and enable the use of devices and equipment that alleviate the burden of the underlying disease.