الفهرس 
Anatomy and Neurochemistry of ApraxiaOnly 14 pages are availabe for public view
 |  | from | 243 |  |  |
| | | from | 243 | | |
Abstract
A stroke is the sudden death of brain cells in a localized
area due to inadequate blood flow (Goldstein and Nussbaum,
1998).
A stroke occurs when blood flow is interrupted to part of
the brain. Without blood to supply oxygen and nutrients and to
remove waste products, brain cells quickly begin to die.
Depending on the region of the brain affected, a stroke may
cause paralysis, speech impairment, loss of memory and
reasoning ability, coma, or death. A stroke also is sometimes
called a brain attack or a cerebrovascular accident (CVA)
(Lapchak and Zhang, 2012).
There are four main types of stroke. Cerebral thrombosis
and cerebral embolism are caused by blood clots that block an
artery supplying the brain, either in the brain itself or in the
neck. These account for 70-80% of all strokes. Subarachnoid
hemorrhage and intracerebral hemorrhage occur when a blood
vessel bursts around or in the brain (Browner et al., 2001).
Risk factors for strokes include high blood pressure,
diabetes, and heart disease. Cigarette smoking also puts a
person at risk for a stroke. Brain tumors are abnormal tissue
growths in the skull. They may be secondary tumors caused by
the spread of cancer through the body (Thomson, 2009).
Apraxia is a disorder of the execution of learned
movements which cannot be accounted for by weakness,
incoordination, or sensory loss, nor by incomprehension of, or
inattention to commands (Can Heugten, 2001).
Summary
-166-
Apraxia is caused by brain damage related to conditions
such as head injury, stroke, brain tumor, and Alzheimer’s
disease. The damage affects the brain’s ability to correctly
signal instructions to the body. Forms of apraxia include the
inability to say some words or make gestures (Chin et al.,
1998).
Various conditions cause apraxia, and it can affect people
of all ages. A baby might be born with the condition. A car
accident or fall that resulted in head trauma could lead to
apraxia (Liepmann et al., 1988).
Apraxia is caused by conditions that affect parts of the
brain that control movements. Apraxia is a result of damage to
the brain’s cerebral hemispheres. These are the two halves of the
cerebrum and are the location of brain activities such as
voluntary movements (Black et al., 2001).
There are several types of apraxia, and a patient could be
diagnosed with one or more forms of this condition. The types
of apraxia include:
Buccofacial or orofacial apraxia is the inability of a person
to follow through on commands involving faces and lip
motions. These activities include coughing, licking the lips,
whistling, and winking. Also known as facial-oral apraxia, it
is the most common form of apraxia (National Institute of
Neurological Disorders and Stroke, 2009).
Limb-kinetic apraxia is the inability to make precise
movements with an arm or leg.
Summary
-167-
Ideomotor apraxia is the inability to make the proper
movement in response to a command to pantomime an
activity like waving.
Constructional apraxia is the inability to copy, draw, or build
simple figures.
Ideational apraxia is the inability to do an activity that
involves performing a series of movements in a sequence. A
person with this condition could have trouble dressing,
eating, or bathing. It is also known as conceptual apraxia.
Oculomotor apraxia is characterized by difficulty moving
the eyes.
Verbal apraxia is a condition involving difficulty
coordinating mouth and speech movements. It is referred to
as apraxia of speech by organizations including the
American Speech Language Hearing Association (ASHA)
(Sirven and Malamut, 2008).
A person diagnosed with apraxia may also have aphasia, a
condition caused by damage to the brain’s speech centers. This
results in difficulty reading, witting, speaking, and
understanding when others speak (Tanner, 2007).
Diagnosis of apraxia could begin with testing of its
underlying cause. Testing for conditions like a stroke or cancer
includes the MRI (magnetic resonance imaging) and CT
scanning (computer tomography scanning). A brain biopsy is
used to measure changes caused by Alzheimer’s disease. In all
cases, the physician takes a family history. Head trauma that
could cause apraxia is first treated in the emergency room
(Ropper and Brown, 2005).
Summary
-168-
Other diagnostic treatment is related to identifying the type
of apraxia. For example, the physician may ask the patient to
demonstrate how to blow out a candle, wave, use a fork, or use
a toothbrush (Ropper and Brown, 2005).
The treatment for apraxia usually involves rehabilitation
through speech-language therapy, physical therapy, or
occupational therapy (Bratton, 2010).
Speech-language therapy focuses on helping the patients
learn or regain communication skills. Therapists teach exercises
to strengthen facial muscles used in speech. Other exercises
concentrate on patients learning to correctly pronounce sounds
and then turn those sounds into words (Johnson and Jacobson,
2007).
Occupational and physical therapies focus on helping
patients regain the skills impaired by apraxia. Physical therapy
exercises concentrate on areas such as mobility and balance.
Occupational therapy helps patients relearn daily living skills
(Ferguson, 2008).
The prognosis for apraxia depends on factors such as what
caused the condition. While Alzheimer’s is a degenerative
condition, a child with verbal apraxia or a stroke patient could
make progress (Coffey et al., 2007).