Definition

Apraxia happens when you are unable to do learned movements or gestures. You may have the desire and the physical ability to do the movements, but you cannot. This is usually due to brain damage, such as a stroke or a brain tumor. There are many types of apraxia. If you have this condition, you may also have aphasia. Aphasia is a language disorder.

Stroke

Stroke can cause brain damage, which can lead to apraxia.

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Causes

Apraxia is caused by diseases or damage to the cerebral hemispheres in the brain, such as:

• Stroke
• Brain tumor
• Trauma to brain
• Infection
• Degenerative brain disease, such as:
  • Alzheimer’s disease
  • Frontotemporal dementia (a syndrome associated with shrinking of the frontal and temporal anterior lobes of the brain)
  • Huntington’s disease
  • Corticobasal ganglionic degeneration (CBD)

Risk Factors

Since this condition may be due to stroke, it is important to know the risk factors for stroke, such as:

• Age: 60 or older
• Prior stroke or cardiovascular disease
• Prior transient ischemic attack (TIA)
• High blood pressure
• High cholesterol
• Diabetes
• Smoking
• Dialysis (treatment that takes over the job of the kidneys when they fail)

Talk to your doctor if you have any of these risk factors.

Symptoms

The following is a list of some of the common forms of apraxia and their symptoms:

• Buccofacial or orofacial apraxia (common)—inability to make facial movements, such as winking, whistling, or sticking out tongue
• Constructional apraxia—inability to copy or draw simple figures or to construct two- or three-dimensional forms
• Gait apraxia—marked by shuffling steps, stooped posture, halting steps, inability to step over obstacles
• Conceptual apraxia—inability to select or use tools or objects properly, inability to make complex coordinated movements and to do tasks in order
• Limb-kinetic apraxia—inability to make fine precise movements with hands or fingers (eg, manipulating coins)
• Ideomotor apraxia—inability to copy movements or make gestures, inability to do a function on command

Diagnosis

Your doctor will ask about your symptoms and medical history. She will also do a physical exam. Tests may include:

• Neurological evaluation to isolate deficit—You may be asked to:
  • Imitate posture, movement, sequences
  • Draw shapes
  • Assemble designs
  • Pick up or rotate coins
  • Select a tool (eg, a hammer) and demonstrate how to use it
  • Arrange movements in sequence
• Examination of muscles used in speech
• Assessment of walking skills
• MRI scan—a test that uses magnetic waves to make pictures of structures inside the brain
• CT scan—a type of x-ray that uses a computer to make pictures of structures inside the brain

Treatment

Your treatment depends on what kind of apraxia you have. Families should ask the doctor about individualized treatment programs, which may include:

• Physical therapy
• Occupational therapy
• Speech therapy
• Cognitive rehabilitation

Treatment of the underlying cause of the apraxia is also important.

Prevention

It may be difficult to prevent this condition. Since it is strongly linked to stroke, following steps to prevent stroke may help. Some of these steps include:

• Exercise regularly.
• Eat a healthful diet.
• Quit smoking and limit how much alcohol you drink.
• Check your blood pressure often.