Apraxia

 

Apraxia is an isolated disorder and uncommon gestural. This infrequent anomaly results from brain damage that can have various origins (traumatic, infectious, etc.). Patients with apraxia have difficulty memorizing or performing a set of movements necessary to complete simple or complex tasks, despite having intact physical ability. The diagnosis of apraxia is essentially clinical, but neuropsychological tests can confirm it, and its cause specified by imaging tests. There is no cure for apraxia. Support by physiotherapy and telehealth psychiatry services makes it possible to adapt to the patient's environment and facilitate daily life.

Definition and Symptoms

What is Apraxia?

The term apraxia derives from the word "praxis," which designates every human being's capacity to perform gestures. More or less complex, the latter can be carried out with or without an object and be associated or not with action. Apraxia is therefore characterized by a difficulty in carrying out a sequence of gestures.

There are various forms of apraxia depending on the part of the brain-injured, including ideomotor apraxia in the event of the parietal lobe's involvement and creativity or constructive apraxia in the event involvement of the parietal-temporal-occipital junction.

Note that agraphia (inability to write) and aphasia of expression (impairment of speech) are also apraxia forms.

Usually, apraxia is caused by damage to the brain, specifically the parietal lobes or nerve pathways. The affected areas of the brain are responsible for memorizing the learned sequences of movements. These lesions may be related to a tumor, injury, infection, vascular disease ( stroke ), or dementia.

What are The Symptoms?

Patients suffering from apraxia are no longer able to memorize or accomplish a sequence of movements to carry out more or less complex tasks. For example, it is difficult for them to press a button, even though their hands are physically able to do so.

Ideomotor apraxia results in an inability to perform a verbal command gesture when spontaneous activity and reflexes are intact. For example, the patient cannot make the sign of the cross if asked, while he will be able to do so spontaneously upon entering a church. Note that this type of apraxia is associated with aphasia.

To know! Aphasia is the medical term that designates in the individual, a partial or total loss of the capacity to express oneself or understand the written and spoken language.

Ideational apraxia involves a disturbance in the coordination of movement when an action requires the use of an object such as dressing or lighting a candle, for example. The gestures are jerky and confused. It is complicated for the patient to follow a specific course of action. This type of apraxia is often associated with Wernicke's aphasia and homonymous lateral hemianopsia (loss of the right or left side of the field of vision).

To know! Wernicke's aphasia is also known as receptive or sensory aphasia. The patient can express himself, but the chosen words are inappropriate, the sentence's construction illogical, and the flow too high, which makes his speech incomprehensible.

Constructive apraxia is manifested by a difficulty in apprehending the spatial relationships of objects. For example, it is difficult for patients to graphically reproduce simple or complex figures. This apraxia can sometimes be associated with Wernicke's aphasia.

Dynamic apraxia is characterized by an inability to perform a sequence of rapid movements on demand according to a set schedule. For example, the patient cannot successfully and rapidly present his fist, palm, and finally, his hand's edge.

It also exists :

·         The apraxia of the dressing which prevents the patient from performing actions considered to be simple or routine such as tying their laces or buttoning their shirt;

·         Oral and facial apraxia, manifested by difficulty in making movements with the face such as whistling or sticking out the tongue.

Individuals with apraxia of speech are incapable of producing the sounds fundamental to verbal expression. Indeed, patients do not manage to initiate, coordinate, or perform the muscle movements essential to speech.

Finally, some forms of apraxia may only affect the performance of a few very specific tasks, such as buttoning your shirt, tying your laces, or even picking up a phone.

Generally speaking, apraxic patients suffer from a loss of their autonomy in daily tasks. It should be noted that the apraxia caused by a cerebrovascular accident (CVA) evolves in a more stable way, even benefits from an improvement of its symptoms.

Risk Factors

Abnormalities in the FOXP2 gene appear to raise the risk of childhood apraxia of speech (CAS) and other speech and language illnesses. The FOXP2 gene may be intricate in how certain nerves and pathways in the brain develop. Researchers continue learning how abnormalities in the FOXP2 gene may affect motor coordination and speech and language handling in the brain.

Complications

Various children with childhood apraxia of speech (CAS) have other difficulties that affect their ability to communicate. These difficulties aren't due to CAS, but they may be seen along with CAS.

Symptoms of difficulties that are often existing along with CAS include:

Delayed languages, such as trouble understanding speech, reduced vocabulary, or trouble using correct grammar when placing words together in a phrase or sentence

Delays in intellectual and motor development and difficulties with reading, spelling, and writing

Troubles with gross and fine motor movement skills or coordination

Hypersensitivity, in which the child may not like some textures in clothing or the texture of certain foods, or the child may not like tooth brushing