Apraxia

Specialty: Neurology.

• loss of learned motor skills
• inability to execute intentional movements

Why it occurs

• Ischemic stroke in the dominant hemisphere (typically left parietal or premotor cortex)
• Frontotemporal lobar degenerative dementia (corticobasal variant) or Alzheimer's disease
• Invasive brain tumors of the left parietal lobe or corpus callosum (sympathetic apraxia)
• Chronic traumatic encephalopathy
• Multiple sclerosis with involvement of motor association fibers

Initial workup

Formal neurological examination of motor gesture (ask the patient to imitate the use of common tools such as a hammer, a toothbrush or to perform abstract gestures such as saluting militarily); High definition brain MRI; Complete neuropsychological evaluation to differentiate ideatory apraxia (failure in the sequence of the motor plan) from ideomotor apraxia (failure in the execution of the individual gesture).

Standard management

• There are no specific drugs for isolated apraxia
• Continuous neuropsychological support and rehabilitation treatment, occupational therapy focused on the simplification of daily tasks and repetitive stimulation of common practices.