Apraxia (inaction, divergence) – a disease at which the patient cannot execute any movements or gestures though has physical abilities and desire for their performance. At this disease big parencephalons, and also conduction paths of a corpus collosum are surprised. Apraxia can develop after the had stroke, a tumor of a brain, an injury of a brain, an infection, degenerative diseases of a brain (Alzheimer's disease, frontotemporal dementia, Huntington disease, a kortikobazalny ganglionic degeneration).
Distinguish unilateral apraxia at which disturbances of movements are shown only on the one hand persons or bodies, and bilateral. This disease is classified by symptomatic manifestations, and also by localization of defeat of parencephalons. On an arrangement in a brain allocate frontal, motor, premotorny, cortical and bilateral apraxia. At frontal apraxia the sequence of motive acts as a result of defeat of prefrontal area of parencephalons is broken. At motor apraxia the patient is capable to plan necessary actions, however he cannot execute them. At premotorny apraxia the premotorny area of bark of big hemispheres is surprised owing to what ability to transform the simple movements in more difficult is lost. Bilateral apraxia arises at bilateral defeat of the lower parietal lobe of parencephalons.
On types of cognitive frustration and skills apraxia happens akinestichesky, anamnestic, ideatorny, ideokinetichesky, articulation, kinaesthetic, constructive, oral, space and afferent. The most difficult type of a disease is articulation apraxia. Articulation apraxia is characterized by inability of the patient to articulately pronounce words, despite the absence of paresis and paralyzes of bodies of an articulation. Akinestichesky apraxia is caused by insufficient motivation to the movement. The anamnestic type of a disease is characterized by disturbance of autokinesias. Ideatorny – impossibility to designate the sequence of actions for implementation of feints. The kinaesthetic type of a disease is characterized by disturbance of arbitrary motive acts. At a constructive type of a disease the patient is not capable to make the whole subject of separate parts. Space apraxia – disturbance of orientation in space.
At motor apraxia there is a disturbance of both spontaneous actions, and actions for imitation. This type of a disease most often happens unilateral. Motor apraxia is divided into two look – melokinetichesky and ideokinetichesky. At ideokinetichesky apraxia the patient is not capable to carry out consciously the simple movements, but at the same time can execute them accidentally. It performs simple operations correctly, but not on a task. The patient usually confuses the movements (touches a nose instead of an ear and. etc.). Melokinetichesky apraxia is shown in distortion of structure of the movements making a certain action and replacement with their uncertain movements in the form of removing and drawing apart fingers instead of squeezing a hand in a fist or to shake finger.
Afferent apraxia usually develops against the background of damage of a postcentral (parietal) cerebral cortex. This disease is characterized by inability of the patient to reproduce single poses (manual and hand, oral and articulation). However, similar poses at this type of a disease easily are reproduced together with usual involuntary actions – clothing, meal.
Constructive apraxia is considered the special and the most often found type of a disease. It develops at defeat of a parietal lobe, both right, and left hemisphere. At this disease the patient is at a loss or cannot represent, copy on memories of a figure of animals and the person, geometrical figures. At the same time the patient distorts object contours, does not finish drawing its separate elements and details. Copying a human face, he can draw one eye over another, not draw some parts of the face. At constructive apraxia there are difficulties with the choice of the place for drawing on paper.
Psychiatrists and neurologists are engaged in treatment of apraxia, everything depends on a look and the reason of disturbances. Individual schemes of treatment using physical therapy, logopedics and labor training are most often appointed. Patients with similar disturbances need the psychologist, the nurse and the caseworker.
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