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Ref No: 2302

Distinguish between the different forms. How may they be best explained?

Apraxia

Apraxia is a complicated disorder of the nervous system in which an individual is unable to perform tasks or movements when asked, even though the requestor command is understood, they are willing to perform the task, the muscles needed to perform the task are functional and the task may have already been learned.

Hence per Encyclopedia Britannica, Apraxia is the inability to carry out useful or skilled acts while motor power and mental capacity remain intact. The areas of the brain affected all are parts of the cerebral cortex and include the parietal lobes, frontal lobes (especially the premotor cortex, supplementary motor area), or corpus callosum and rarely some part of the temporal lobe. These areas can be of the dominant side or the non-dominant side. As tested by imitation and object use pantomime, has been found in approximately 50% of patients with left hemisphere damage and in <10% with right hemisphere damage. This suggests that many patients have a bilateral representation of praxis functions (De Renzi, 1989). These are the parts of the brain that control movement of the voluntary muscles. Damage to these is responsible for disturbances in performing voluntary movements intended by an individual.  Apraxia can arise from many diseases or maybe a result of damage to areas of the brain mentioned above. The damage affects the brain’s ability to correctly signal instructions to the body. There are several conditions that can lead to but most common are stroke and head injury. It is not age-specific i.e.  can occur to a newborn as well as to a man of age 60. Therefore, it is a disease of all ages. Heilman defined in negative terms, characterizing it as “a disorder of skilled movement not caused by weakness, akinesia, differentiation, abnormal tone or posture, movement disorders such as tremors or chorea, intellectual deterioration, poor comprehension, or uncooperativeness (Heilman, 1985).”

Error Types in Function:

• Omissions
• Difficulty terminating movements
• Repetitions
• Disturbances to the order of movements in sequence
• Difficulties co-ordinating limbs in time and space
• Perseveration • Performance in the wrong plane
• Using body part as an object
• Verbalize performance without completing (Grieve and Gnanasekaran, 2008)

Signs and symptoms:

A person suffering from apraxia has no physical paralysis yet he would be unable to perform simple voluntary movements like combing hair. Prompts or commands are heard but not executed. The movements made somehow are very clumsy, inappropriate and not in control. Apraxia also causes movements that are completely unintentional. There are speech disturbances and gait disturbances. Based on areas of body affected by the disease, apraxia has been divided into several types which may or may not occur at the same time in one patient. The main forms of  are enlisted below:

1. Oculomotor
2. Bucco-facial or orofacial
3. Limb-kinetic
4. Ideational
5. Ideomotor
6. Apraxia of speech or verbal
7. Constructional  …………………………………………..