Inability to use objects and perform tasks

Definition

A person with praxia cannot perform previously-learned tasks or movements even though the muscles and senses work properly.

Considerations

Apraxia occurs in 3 major forms:

• Ideomotor apraxia. The affected person is no longer capable of voluntarily performing a learned task when given the necessary objects. For instance, if given a screwdriver, the person may try to write with it as if it were a pen. Or, given a toothbrush, the person might try to comb the hair with it.
• Ideational apraxia. The affected person can no longer carry out learned complex tasks in the proper order, such as putting on socks before putting on shoes. The individual cannot mime specific tasks without the objects, such as opening a letter, or pouring a glass of water.
• Apraxia-like syndrome. Strictly speaking, these disorders are not apraxia:
  • Lid-opening apraxia (difficulty in opening the eyelids)
  • Gait apraxia (difficulty in starting to walk)
  • Dressing apraxia (difficulty in buttoning a shirt or tying a shoelace)

Common Causes

• Dementia
• Stroke
• Hemodialysis (prolonged)
• Neurodegenerative illness
• Brain tumor

Home Care

Safety measures should be taken to compensate for weakness, confusion, sensory deficiencies, or seizures that may accompany this problem. Participation in normal activities is encouraged.

Extreme patience should be exercised with people who suffer from apraxia. Take time to demonstrate tasks and allow sufficient time for the afflicted person to perform the task. Avoid complex directions.

Call your health care provider if

Call your health care provider if there is unexplained and persistent lack of ability to do simple, routine acts.

What to expect at your health care provider's office

The medical history will be obtained and a physical examination performed. If there are seizures, the patient will be stabilized first.

Medical history questions documenting your symptom in detail may include:

• Do you undergo hemodialysis (for chronic kidney failure)?
• What other symptoms are also present? Especially, is there:
  • Confusion or disorientation
  • Memory loss
  • Weakness or paralysis of any body part
  • Numbness or tingling of any body part
  • Seizures

The physical examination will include emphasis on examination of the nervous system.

Diagnostic tests that may be performed include:

• CT scan or MRI of the head or affected area
• Blood tests
• Lumbar puncture
• X-ray

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