πβA show of hands: upper limb apraxia types and assessment. π§ π§΅
#Neurology
#Neurotwitter
#Apraxia
#Teaching
ππ₯Έ
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#Neurology
#Neurotwitter
#Apraxia
#Teaching
ππ₯Έ
1/π§΅
Disclaimer π¨β οΈ
This tweetorial is based on a great chaper from this amazing book. β¬οΈπ
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This tweetorial is based on a great chaper from this amazing book. β¬οΈπ
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But first....what is apraxia?
"disturbances in learned skilled movements due to a cognitive defect in motor programming, such as errors in pantomiming brushing oneβs teeth or gesturing βgood-bye." π€
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"disturbances in learned skilled movements due to a cognitive defect in motor programming, such as errors in pantomiming brushing oneβs teeth or gesturing βgood-bye." π€
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π¦ͺTo properly assess praxis:
1οΈβ£ Exclude other cogntiive deficits (language and attention) π£οΈ
2οΈβ£ Exclude primary motor or sensory deficits πͺ
3οΈβ£ Observe for any unusual posturing or movements as some may appear when assessing praxis
4οΈβ£ Start with verbal commands
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1οΈβ£ Exclude other cogntiive deficits (language and attention) π£οΈ
2οΈβ£ Exclude primary motor or sensory deficits πͺ
3οΈβ£ Observe for any unusual posturing or movements as some may appear when assessing praxis
4οΈβ£ Start with verbal commands
4/π§΅
1οΈβ£ Ideomotor apraxia
π§ No pantomime to verbal command
πͺ No recognition of gestures
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π§ No pantomime to verbal command
πͺ No recognition of gestures
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2οΈβ£ Dissociation Apraxia
No pantomiming on verbal commands
Can imitate and understand gestures πͺ
Aphasia is frequently seen π£οΈ
Can imitate meaningless gestures and do well with real object use π
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No pantomiming on verbal commands
Can imitate and understand gestures πͺ
Aphasia is frequently seen π£οΈ
Can imitate meaningless gestures and do well with real object use π
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3οΈβ£ Ideational apraxia
Inability to correctly sequence a series of movements in a multistep action. πͺ₯π₯ͺ
Patients cannot order individual gestures, to complete a goal.π₯
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Inability to correctly sequence a series of movements in a multistep action. πͺ₯π₯ͺ
Patients cannot order individual gestures, to complete a goal.π₯
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4οΈβ£ Conceptual apraxia
Semantic disorderπ§
Wrong action to command
Wrong action for a tool
Using πͺ₯ as a π¨ or a π₯ as a comb
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Semantic disorderπ§
Wrong action to command
Wrong action for a tool
Using πͺ₯ as a π¨ or a π₯ as a comb
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5οΈβ£ Limb-kinetic apraxia
Finger fine movements ποΈ
How to assess it?
π
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Finger fine movements ποΈ
How to assess it?
π
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Some final considerations
π₯ Most of apraxias affect both extemitires (exceptions exist)
π₯ Most of them are related to left parietal injury
π₯ Dressing apraxia is not an "apraxia" it's a visual-spatial deficit
10/π§΅
π₯ Most of apraxias affect both extemitires (exceptions exist)
π₯ Most of them are related to left parietal injury
π₯ Dressing apraxia is not an "apraxia" it's a visual-spatial deficit
10/π§΅
Final disclaimer β οΈ
This is only a summary, more types of apraxia exist. The main objective of this 𧡠was to summarize the easieast chapter that I've found (so far) regarding this extensive and complicated (nevertheless fascinating) topic.
11/π§΅
This is only a summary, more types of apraxia exist. The main objective of this 𧡠was to summarize the easieast chapter that I've found (so far) regarding this extensive and complicated (nevertheless fascinating) topic.
11/π§΅
References:
1.- MF. Mendez. The mental status examination handbook. 1st Edition. Elsevier. 2021. P 119. Praxis.
2.- Pract Neurol. 2016 Aug;16(4):317-22. doi: 10.1136/practneurol-2015-001354
1.- MF. Mendez. The mental status examination handbook. 1st Edition. Elsevier. 2021. P 119. Praxis.
2.- Pract Neurol. 2016 Aug;16(4):317-22. doi: 10.1136/practneurol-2015-001354
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