Gait Disorders

Definition

Apraxia is the inability to do learned movements or signals. You may have the desire and the physical ability to do the movements, but you cannot. There are many types of apraxia.

Causes

Apraxia is caused by diseases or damage in the brain, such as:

• Stroke
• Brain tumor
• Brain injury
• Infection
• Brain disease, such as:
  • Alzheimer disease
  • Frontotemporal dementia—a syndrome associated with shrinking of the frontal and temporal anterior portions of the brain
  • Huntington disease
  • Corticobasal ganglionic degeneration (CBD)

Stroke

Stroke can cause brain damage, which can lead to apraxia.

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Risk Factors

Apraxia may be due to stroke. Stroke is more common in older adults.

Factors that may increase your risk of stroke include:

• Prior stroke or cardiovascular disease
• Prior transient ischemic attack (TIA)
• High blood pressure
• High cholesterol
• Diabetes
• Smoking
• Dialysis treatment, which takes over the job of the kidneys when they fail

Symptoms

Some common forms of apraxia and their symptoms include:

• Buccofacial or orofacial apraxia—inability to make facial movements, such as winking, whistling, or sticking out the tongue
• Apraxia of speech—difficulty performing the movements needed to make speech
• Constructional apraxia—inability to copy or draw simple figures or to make 2- or 3-dimensional forms
• Gait apraxia—difficulty walking, which can lead to an increased risk of falls
• Conceptual apraxia—inability to select or use tools or objects properly, to make complex movements at the same time, and to do tasks in order
• Limb-kinetic apraxia—inability to make fine, exact movements with hands or fingers such as handling coins
• Ideomotor apraxia—inability to copy movements or make signals, or to do a function on command
• Dressing apraxia—inability to dress oneself

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

A neurological exam may be done. You may be asked to:

• Copy posture, movement, and sequences
• Draw shapes
• Put together designs
• Pick up or rotate coins
• Select a tool, such as a hammer, and demonstrate how to use it
• Arrange movements in sequence

Images may be taken of your brain. This can be done with:

• MRI scan
• CT scan

Other tests may include:

• An exam of the muscles used in speech
• A speech assessment
• Evaluation of walking skills

If you are diagnosed with apraxia, you could also have aphasia . Aphasia is a language disorder.

Treatment

Your treatment depends on what kind of apraxia you have. Families should ask about individualized treatment programs such as:

• Physical therapy
• Occupational therapy
• Speech therapy
• Cognitive rehabilitation

It is also important to treat the cause of the apraxia.

Prevention

It may be difficult to prevent this condition. It is strongly linked to stroke. Following steps to prevent stroke may help. Some of these steps include:

• Exercise regularly.
• Eat a healthy diet .
• If you smoke, talk to your doctor about ways to quit .
• Limit how much alcohol you drink.
• Check your blood pressure often.