Apraxia: classification

Definition of apraxia

The apraxia, the acquired gesture disorder par excellence, it represents the "impossibility or difficulty of coordinating gestures, despite the patient's motor skills remaining unharmed. This is a neuropsychological disorder, generally resulting from brain trauma: strictly speaking, it is understandable how the" apraxia proves to be a complex and heterogeneous disorder. In this article we will analyze the various forms of apraxia, classified on the basis of the level of coordination / processing of the motor gesture.

Apraxia and related diseases

Before proceeding with the classification of the various forms of apraxia, a premise is necessary.

The incidence of apraxia is considerable in brain-damaged subjects: in fact, it has been observed that 30% of patients with lesions affecting the left cerebral hemisphere also suffer from some form of apraxia, more or less severe. "introductory article, most apraxic patients are unaware of their deficit, are normo-intelligent, are not disabled, and both will and motor skills remain unaffected. In the past, it was customary to consider "apraxia" within a pathological picture directly related to other movement disorders: currently, this hypothesis has been discarded, since apraxia is understood as a disorder in its own right, yes associated to other movement disorders, but not directly related.

Classification

First of all, "apraxia is distinguished on the basis of the affected areas: apraxia of the limbs (ideomotor and ideational), oral (constructive and buccofacial) and trunk. A" further classification of the forms of apraxia is carried out according to the degree of elaboration of the motor gesture.

• Ideomotor apraxia: typical consequence of cerebral lesions of the left hemisphere (in particular: trauma of the corpus callosum, damage to the parietal lobe, frontal lesion of the lateral pre-motor region). The patient is unable to translate the gesture devised (aimed at a purpose) in movement: by affecting the individual muscle groups, ideomotor apraxia denies the subject the possibility of performing a voluntary movement, while mentally planning it correctly.
• Ideational (or ideational) apraxia: the affected subject is unable to perform the movements in the right temporal succession. In other words, the apraxic is unable to mentally design the gesture and is unable to control its movements. Typical pathology resulting from lesions in the premotor cortex and in the secondary parietal cortex.
• Constructive apraxia: the apraxic patient is unable to reproduce two / three-dimensional configurations, either by imitation or by memory. Most of the time, constructive apraxia is a consequence of brain lesions affecting the right or left hemisphere.
• Buccofacial apraxia: the affected patient is unable to perform indicative movements with the mouth, pharynx or neck muscles, even under imitative stimulation. This type of apraxia is related to trauma of the left hemisphere, of the pre-Rolandic and post-Rolandic region.
• Trunk apraxia: Still much discussed, trunk apraxia mainly consists of the patient's inability to coordinate trunk movements and perform them correctly for a purpose (for example, the patient is unable to sit or stand up from a chair ).

Other types of apraxia include:

• Verbal apraxia: the patient is denied the possibility of coordinating the movements of the mouth, therefore of correctly articulating words.
• Motor apraxia: the patient's significant gestures are disorganized, the movements are not very spontaneous and very strained. They typically involve the half of the body affected by the affected brain area.
• Acrokinetic apraxia: the apraxic patient gesticulates in an awkward and bizarre way, almost crystallized; moreover, the movements, always disorganized, are devoid of spontaneous coordination.

All the forms described above of apraxia are united by a fundamental aspect: apraxia is not simply related to the movement as such, rather it affects the organization, planning and coordination of gestures and movements. The apraxic patient is unaware of how to do that given action, much less of to translate the sequentiality of the movements according to a defined scheme. In other cases of apraxia, the patient is unable to imagine that gesture, or to ideally represent it before performing it.
Clearly, the degree of severity of apraxia is directly proportional to the severity of the brain damage caused.

Other articles on "Apraxia: classification"

1. Apraxia
2. Apraxia: diagnosis, therapies and prognosis
3. Apraxia in Brief: A Summary of Apraxia