What Is Apraxia?

Apraxia is a disorder of use, which refers to the dysfunction of high-level parts of the brain after brain injury, manifested as the use of limbs in the absence of paralysis and deep sensory disorders. It is acquired, acquired, and purposeful. Disability in the use of proficiency. The patient is conscious and fully understands the required action, but cannot perform it. He cannot complete the purposeful technical actions that he has already mastered and can complete before the illness.

Basic Information

English name: Apraxias
Visiting department: Neurology

Common causes: Dysfunction of advanced parts of the brain after brain injury
Common symptoms: Impaired facial use, impaired hand use, impaired use of trunk and lower limbs, impaired use of article handling, impaired painting, etc.

Clinical manifestations of apraxia

Facial dysfunction

The patient is first required to make various actions based on verbal instructions, and then imitate various actions based on visual instructions, such as pouting, whistling, smiling, closing eyes, frowning, opening, closing, shaking his head, etc. Facial dysfunction is bilateral and mostly invades the muscles dominated by the facial nerves. The effects of dysfunction on various movements are inconsistent, some of which are involved in exercise, while others can whistle but not cough. Sometimes the patient cannot do an action at will, but completes it unintentionally. The patient also showed a movement error, such as closing his eyes and sticking out his tongue.

2. Hand using obstacles

Ask the patient to perform the following actions: adduction and abduction of fingers, separation and closing of fingers, pronation and abduction of hands, thumb to palm, slap clothes, itching, knuckle knocking on the door, popping fingers, saluting and waving, use of hands Obstacles resemble facial features.

3. dysfunction of the trunk and lower limbs

The examiner can ask the patient to perform the following actions: change the lying position, sit up from the lying position, bend the trunk forward or side, walk, run, jump on one leg, hit the floor with the heel, cross the legs, turn the body left, Turn right and draw a circle or write a word in the air. Obstacles to use may be limited to one side and both legs should be examined separately.
Patients with dysfunction of the trunk and lower limbs have a very special walk. The patient takes a step forward and hesitates, and then uses the same leg to take another step to stop. The patient seems to forget which part of the body should be exercised during the turning exercise; when writing numbers or drawing circles with the lower limbs, the patients move the lower limbs in random.

4. Barriers to the use of item handling

Obstacles in the handling of items are manifested in the inability to use an item correctly to complete certain tasks and actions. One-hand test and two-hand test can be performed during the examination: the first-hand test allows patients to pitch, brush their teeth, comb their hair, etc. The two-hand test is commonly used to allow patients to scratch matches, light cigarettes or candles and tie knots. If you don't have an object, you can perform the imaginary action without the actual object.

5. Painting obstacles

The patient was very awkward when painting, the strokes were thick and uneven, the lines piled together or interlaced with each other, and the messy image was difficult to identify. Some paintings are very simple, and omissions or displacements are often made, such as drawing eyes away from the face, or extending an arm from the face, or placing a smoking pipe on a window when painting a house.

6. Structural barriers

The main manifestation is the inability to synthesize multi-angle spatial structures. When the patient has severe structural obstacles, he completely loses the ability to perform tasks, or moves with purpose, blocks, or blocks without purpose, or swings around. The same confusion occurred when copying and copying (placing the building blocks in a good manner).

Apraxia test

1. Blood routine, blood electrolyte, blood glucose, urea nitrogen, and urine routine examinations are of differentiating significance for the diagnosis of the cause.

2. Cerebrospinal fluid examination is also of differentiating significance for the diagnosis of the cause. Including ECG and ultrasound. CT and MRI examinations are helpful for the diagnosis of localization of the nervous system.

Diagnosis of apraxia

This condition is sometimes difficult to distinguish from dynamic apraxia. The true lesion that causes apraxia is the parietal lobe, and the parietal lobe is the co-responsible person for structural apraxia, conceptual apraxia, and conceptual motor apraxia. In patients with conceptual apraxia, the lesions extend to the temporal lobe, while in structural apraxia, the lesions expand to the occipital lobe. More precisely, the lesions are the superior marginal and angular gyrus involving the parietal-occipital transition. The parietal lobe also causes rejective motor apraxia. Apraxias not related to the parietal lobe include dynamic apraxia, mouth-face apraxia, and magnetized apraxia, all of which are caused by frontal lobe lesions.

A diagnosis of apraxia

Apraxia can only be diagnosed without a significant disturbance of consciousness or speech (understanding). The prerequisites for diagnosis are: the patient does not have any dyskinesias, no paralysis, muscle insufficiency, involuntary movement or ataxia, and excludes all types of dementia.