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Thread: Apraxia

  1. #1

    Exclamation Apraxia

    What is meant by apraxia?
    ---text books says it is the INABILITY TO INTIATE A MOTOR ACTIVITY IN THE ABSENCE OF A KNOWN MOTOR OR SENSORY DEFICIT OR ABNORMALITIES IN TONE,POSTURE etc..

    can i get an accurate/specific definition?

    what are the types of apraxia..?pls explain the centres related in terms of dominant and nondominant hemisphere..

    pls explain its circuit and how the lesions affect it..

    WHAT IS ITS CLASSIFICATION?I have heard of a lot of confusing terms like ideamotor apraxia,buccofacial apraxia,dressing apraxia
    WHAT A confuuuuuuuuuuuuussssiiiiiiiion?pls help

    HOW TO TEST FOR APRAXIA?

  2. #2

    Apraxia, Ataxia, Paresis, Paralysis, Spasticity, Clonus, Spasms

    Quote Originally Posted by dranoop
    What is meant by apraxia?
    ---text books says it is the INABILITY TO INTIATE A MOTOR ACTIVITY IN THE ABSENCE OF A KNOWN MOTOR OR SENSORY DEFICIT OR ABNORMALITIES IN TONE,POSTURE etc..

    can i get an accurate/specific definition?

    what are the types of apraxia..?pls explain the centres related in terms of dominant and nondominant hemisphere..

    pls explain its circuit and how the lesions affect it..

    WHAT IS ITS CLASSIFICATION?I have heard of a lot of confusing terms like ideamotor apraxia,buccofacial apraxia,dressing apraxia
    WHAT A confuuuuuuuuuuuuussssiiiiiiiion?pls help

    HOW TO TEST FOR APRAXIA?
    Dranoop,

    May I give you some suggestions for posting on this site? First, you should not make all your text bold. Use regular text and occasionally use bold text to emphasize your point. Second, if you refer to any information from outside of this site, please include the URL link to document the source. Third, please remember that thousands of people read posts on this site and you should take time to compose your question as thoughtfully and clearly as possible. Finally, the announcement and feedback forum is for announcements and questions concerning the operation of the site. Please post scientific questions that are not related to care or cure of spinal cord injury and related conditions to this forum. I just added medicine to the title of the forum to encourage medical questions and discussions.

    Apraxia indicates inability or deficiency in ability to carry out purposeful movement. I disagree with the definition that you provide because it suggests that a person does not have apraxia when there is paresis (partial paralysis) or sensory loss. Apraxia can be superimposed on sensory or other motor deficits. Apraxia is loss or deficiency of motor planning and execution in part of the body, even though ability to initiate movement and sensations in that part of the body may still be intact. It is possible have paresis and sensory loss without apraxia.

    Apraxia differs from ataxia which means loss or deficiency of coordination. For example, cerebellar ataxia is incoordination of muscle movements due to damage of the cerebellum while sensory ataxia is deficiency of coordination due to loss of proprioception and vestibular ataxia is deficiency of coordination due to abnormalities of vestibular (balance) sensory system. Thus, an ataxic movement still has purpose but has deficient coordination while apraxia indicates lack of purposeful movement.

    Apraxia also differs from paralysis which usually indicates loss of voluntary movement. Please note that paralysis does not necessarily indicate apraxia or vice versa. One can have movements that are not purposeful. So, apraxic speech, for example, describes sounds that are made by somebody who can initiate speech but is not properly setting up and executing the motor programming for speech. Apraxic speech differs from ataxic dysarthria which is uncoordinated speech that some might describe as "slurred" speech.

    Paralysis of course does not mean loss of movement. It just means loss of voluntary control. As people with sponal cord injury know, one can have involuntary spasms that are not voluntarily initiated or reflexes that are a result of sensory input that initiates a movement. A good friend of mine would get bruises on her arm from fending off the kicks of her quadriplegic son when she is manipulating his tracheal tube. Christopher Reeve use to get spasm that are so violent that he would throw himself off his wheelchair, no mean feat considering his size.

    Spasticity is a particular type of movement disorder that is characterized by heightened reflexes. This may be in the form of exaggerated reflexes to sensory input, including repeated reflexive movements such as the clonus. It can also manifest in increased muscle stiffness and even rigidity of the muscle to being moved. By the way, spasticity is not the same as spasms. Spasms are involuntary movements that can be either spontaneous or induced by sensory input. They can involve multiple muscles and joints.

    Wise.

  3. #3
    Senior Member Katilea's Avatar
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    Excellent description and first time I really understood the difference.

    I was diagnosed with Ataxia in my early thirties (now 41) and originally it was just in legs I was just a bit wobbly on my feet and needed wheelchair outdoors, as it progressed it started affected other voluntary muscles like speech and my arms.

    At first I thought I might have something else with it as everyone else with Ataxia seemed to have a constant tremor rather than just jerky movements when they tried to do a deliberate action like go to pick something up.

    Then I learnt about Dysmetria (overshooting or undershooting when aiming for something) and that is part of Ataxia combined with Intention tremor (more at the end of the movement than constantly) it sometimes appears to people similar to Athetoid CP.

    I have learnt that keeping arms closer to body or forearms supported reduces the extra movements and has greatly helped me with typing and joystick control - although I still need a keyguard on the smaller iMac keyboard, but can use Intellikeys without one. (giant keyboard with adjustable touch sensitive interface). I use that on Laptop inbed as its a grreat help at night as I'm getting more tired and accuracy is more difficult to achieve aiming for smaller keys.

    I don't know how you would compensate for Apraxia if you can't make purposeful movements (how are you typing?)

    There is a site called WE MOVE thats specifically aimed at movements disorders, they may be able to help you better?

    http://www.wemove.org/

  4. #4
    In an extension of the first post, what functional implications does something like oral apraxia have? I understand volitional movements are affected, but why would that matter? The literature I have found only talks about "blowing bubbles" or "sticking your tongue out"... I have a friend diagnosed with oral apraxia, and I am trying to help him understand the implications.
    Thank you.

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