Results 1 to 2 of 2

Thread: Ideational Apraxia

  1. #1

    Ideational Apraxia

    Hi everyone. Thanks for creating this site, Mr. Young. May I have this opportunity to clarify my doubt regarding patients' neurological assessment.

    During my practise ( as junior physician ), I had come across a patient with sensory loss over his left half, resulting from stroke ( right MCA territory infarct ). He had diminished sensation to touch and pain; but had normal muscle power and coordination.

    He was unable to quote the number I had written on his left palm; nor was he able to name objects placed in this hand ( sensory agnosia ).

    When asked, " show me how you would comb your hair ", he could perform the task with his right hand, but not with the left . The patient was right handed. Can this be termed 'ideational apraxia' ; or should I not have tested his left hand ( for this particular task), for having had sensory deficit already? Moreover left is not the patient's dominant side.

  2. #2
    Quote Originally Posted by Sharan Paul
    Hi everyone. Thanks for creating this site, Mr. Young. May I have this opportunity to clarify my doubt regarding patients' neurological assessment.

    During my practise ( as junior physician ), I had come across a patient with sensory loss over his left half, resulting from stroke ( right MCA territory infarct ). He had diminished sensation to touch and pain; but had normal muscle power and coordination.

    He was unable to quote the number I had written on his left palm; nor was he able to name objects placed in this hand ( sensory agnosia ).

    When asked, " show me how you would comb your hair ", he could perform the task with his right hand, but not with the left . The patient was right handed. Can this be termed 'ideational apraxia' ; or should I not have tested his left hand ( for this particular task), for having had sensory deficit already? Moreover left is not the patient's dominant side.
    Sorry that I did not see this earlier. What you have described is clear case of proprioceptive loss on the left side, which is consistent with diminished sensation to touch and a right MCA infarct. The fact that he has little or no muscle loss suggests that his motor cortex is intact. I presume that his movement is coordinated and not ataxic or spastic, which would argue for intact basal ganglia, cerebellum, brainstem, and spinal cord circuits.

    Your observation that he did not use his left hand to comb his hair may or may not be related to his MCA infarct because he may never have used his left hand to comb his hair. I know many people who only comb their hair with their right hand, just like many Chinese would have a hard time using chopsticks with their left hand.

    I moved your post out of the Forum announcement into its own thread. I am sorry that I did not see it earler.

    Wise.

Similar Threads

  1. Apraxia
    By dranoop in forum Science, Medicine, & Technology
    Replies: 3
    Last Post: 02-10-2011, 07:48 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •