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Dr Norina Usma

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Historical Perspective

Classification

Apraxia may be classified into different subtypes based on it's clinical features:

  • Ideomotor apraxia: The most commonly known type of apraxia is Ideomotor apraxia, or decreased performance of skilled motor performances despite integral language, sensory and motor function[1]. Ideomotor apraxia is classically demonstrated when a patient questioned verbally to make a motion with a limb. Patients with Ideomotor apraxia display spatial and temporal errors, inconvenient timing, amplitude, sequencing, configuration, limb position in space[2]. They often use their arm as an object relatively than indicating how to use the object . Patients are frequently able to achieve the same acts without struggle in their daily lives. This process has been called the "voluntary-automatic dissociation"[3][4].These patients have a deficiency in their skill to plan or ample motor actions that depend on semantic memory. They can describe how to achieve a response, but incapable to "imagine" or do the movement. Though the capability to perform an act inevitably when cued remains complete, this is recognized as automatic-voluntary dissociation[5].
  • Constructional apraxia: It is a condition resulting from neurological damage which is demonstrated by the inability to construct and/or copy to command two- and three-dimensional stimuli. Constructional apraxia has been well-thought-out to be a classic sign of a parietal lobe lesion, and as a valuable tool to escalate the spatial abilities functioned by this lobe. It has become gradually clear that Constructional Apraxia is a heterogeneous construct that can be observed with very different tasks that are only slightly interrelated, and hit various kinds of visuospatial, attentional, perceptual, planning, and motor mechanisms[6]. The patient with constructional apraxia is unable to construct, draw, or copy simple configurations, for example intersecting shapes, they have trouble drawing basic shapes or copying a simple diagram[7].

Pathophysiology


Causes

Common causes of Apraxia may include:

  • It could be due to a defect in the brain pathways that comprise memory of learned forms of movement. Any disease that is related to these areas can lead to apraxia, stroke, dementia are the leading causes, but there are many other causes as well.
  • The lesion cause could be because of certain metabolic, neurological, or other disorders that influence the brain, predominantly the frontal lobe, inferior parietal lobule of the left hemisphere of the brain. In this area, complex, 3-dimensional depictions of formerly learned patterns and movements are stored[8].
  • Patients with apraxia cannot regain these representations of stored, skilled actions.Therefore, patients with apraxia are unable to perform daily living activities well.

Differentiating Xyz from Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications, and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

There are no x-ray findings associated with apraxia.

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

References

  1. https://books.google.com/books?hl=en&lr=&id=MT_RCwAAQBAJ&oi=fnd&pg=PP1&ots=-nYhkcgHZg&sig=jXDl07y9RD1-YsTjtHVfn07hUZI#v=onepage&q&f=false. Missing or empty |title= (help)
  2. https://pubmed.ncbi.nlm.nih.gov/11373145/. Missing or empty |title= (help)
  3. https://pubmed.ncbi.nlm.nih.gov/9184099/
  4. https://pubmed.ncbi.nlm.nih.gov/8292325/
  5. https://pubmed.ncbi.nlm.nih.gov/8292325/
  6. https://www.tandfonline.com/doi/abs/10.1080/02643298708252037?journalCode=pcgn20
  7. https://rarediseases.org/rare-diseases/apraxia/
  8. https://rarediseases.org/rare-diseases/apraxia/#:~:text=Apraxia%20is%20caused%20by%20a,left%20hemisphere%20of%20the%20brain. Missing or empty |title= (help)