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Apraxia: causes, symptoms, diagnosis, treatment
Last reviewed: 23.04.2024
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Apraxia is the inability to perform targeted motor acts that are customary for the patient, despite the absence of primary motor defects and the desire to produce this action, which develops as a result of brain damage. The diagnosis is made on the basis of clinical symptoms, data of neuropsychological and visualization (CT, MRI) studies. The prognosis depends on the nature and extent of the lesion, as well as on the age of the patient. Specific treatment is not developed, but physiotherapy and occupational therapy can accelerate functional recovery.
Apraxia occurs due to brain damage (in case of an infarction, tumor or trauma) or a degenerative process with lesion localization usually in parietal lobes or associated departments where the programs of life-assimilated actions are stored. Less often, apraxia develops when other parts of the brain (premortor cortex, corpus callosum, frontal lobe) are damaged or diffuse processes, in particular in degenerative dementias.
[Symptoms of apraxia
The patient can not comprehend or perform a familiar motor task, although it can perform individual components of complex motion. For example, a patient with constructive apraxia is not able to copy a simple geometric figure, despite the ability to see and recognize stimuli, hold the pen and use it, and understand the task. As a rule, patients do not realize their disease.
During the examination, the patient is asked to perform or repeat familiar motor acts (for example, wave a hand at parting, greet, make a sign "come here", ask to go and stop, show how to open the lock with a key, show how to use a screwdriver, scissors; take a deep breath with a subsequent delay in breathing). In parallel, the doctor checks muscle strength in all involved muscle groups to exclude muscle weakness / paresis as a cause of the existing disorders. Neuropsychological research, as well as information from a physiotherapist and a specialist in occupational therapy, can reveal more complex variants of apraxia.
It is necessary to ask relatives about the extent to which the patient is able to perform daily activities (for example, to use cutlery, a toothbrush, cooking utensils, a hammer and scissors), and to find out whether the patient can write independently.
CT or MRI (with or without angiography) will help clarify the presence and nature of the central lesion (heart attack, hemorrhage, mass effect, focal atrophy). Physical examination usually allows you to identify the main neuromuscular diseases or trauma, which can be confused with apraxia.
Prognosis and treatment of apraxia
As a rule, patients become addicted, in need of help to perform daily activities, at least in the supervisory mode. 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. Physio- and occupational therapy can somewhat improve the function, make the life safer and allow the use of devices and devices that mitigate the burden of the underlying disease.