Apraxia

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The term apraxia will be used here to mean inability to follow a motor command, when this inability is not due to a primary motor deficit or a language impairment. It is caused by a deficit in higher-order planning or conceptualization of the motor task. You can test for apraxia by asking the patient to do complex tasks, using commands such as "Pretend to comb your hair" or "Pretend to strike a match and blow it out" and so on. Patients with apraxia perform awkward movements that only minimally resemble those requested, despite having intact comprehension and an otherwise normal motor exam. This kind of apraxia is sometimes called ideomotor apraxia. In some patients, rather than affecting the distal extremities, apraxia can involve primarily the mouth and face, or movements of the whole body, such as walking or turning around.

The term "apraxia" has also been attached to a variety of other abnormalities that may not fit the simple definition just described —for example, "constructional apraxia" in patients who have visuospatial difficulty drawing complex figures, "ocular apraxia" in patients who have difficulty directing their gaze, "dressing apraxia" in patients who have difficulty getting dressed, and so on.

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