One of the rather complex neuropsychological disorders is kinetic apraxia. Pathology is associated with impaired movement of nerve impulses coming from the receptors in the central nervous system. The reason lies in the defeat of the cerebral cortex, in particular the postcentral region of the dominant hemisphere. Due to pathology, a disorder of voluntary movements of a person begins. The main complication of the disease is manifested in the difficulties of human adaptation in society and the inability to perform certain types of activities.
Problem Description
Kinetic apraxia is a disorder of purposeful movements in which the main component of elementary movements is preserved. A person plans and controls motor activity, but cannot use automated motor skills. As a result, his movements become slow and clumsy.
The disease develops due to damage to the cerebral cortex of the brain or the pathways of the corpus callosum, which are responsible for the consistent organization of movements. Kinetic apraxia is characterized by the breakdown of “kinetic melodies”, which is manifested in a violation of the sequence of motor acts. Moreover, the disease can be limited if the disorder is observed in one half of the body, face or limb. Most often, with pathology of the corpus callosum, left-sided apraxia is manifested. For example, such a kind of kinetic apraxia as hand apraxia is manifested in the inability to use various objects and tools.
The patient must constantly monitor his movements, even in the case of a well-learned action. Many have a steady repetition of any movement.
Causes of pathology
Kinetic apraxia develops as a result of diseases or injuries of the cerebral hemispheres, which include:
- neoplasms of a benign or malignant nature;
- vascular pathology in the brain;
- previous stroke;
- head injuries;
- complications after a neuroinfection;
- Alzheimer's syndrome or frontotemporal dementia;
- Huntington's syndrome, CBD.
The risk group includes:
- persons of advanced age;
- people with cardiovascular disease and those who have previously suffered a stroke;
- people with hypotension and high blood cholesterol;
- persons with diabetes or an artificial kidney.
Symptoms and localization of kinetic apraxia
Depending on the location of the pathology in the brain, the mechanisms that form the basis of purposeful movements are disturbed. For this reason, the disease can occur to varying degrees. Kinetic apraxia develops with damage to the cortex of the postcentral region of the dominant hemisphere of the brain. Right-handed people have a left hemisphere, left-handed people have a right hemisphere.
As a result, a sick person cannot give the limb the desired position even with a sample. With this type of disease, all objective actions are violated:
- the inability to perform movements in a given pattern, for example, to show how to pour tea;
- violation of posture and gait;
- development of the phenomenon of "hand-shovel."
In this case, there is a disorder of all purposeful movements of a certain part of the body, in most cases of the upper limbs, so a person cannot control them.
Diagnosis of the disease
To make a diagnosis, a neurologist conducts special testing, a neurological examination and neuropsychiatric tests. For this, the doctor asks the patient:
- perform certain movements in the specified sequence;
- draw a given shape;
- assemble a simple structure;
- raise a coin;
- show how to use some subject;
- walk a certain distance to assess walking skills.
To clarify the location of the pathological area in the brain, MRI, CT and NRM are prescribed. In addition, a neurologist differentiates the disease with paresis and paralysis. After the examination, the final diagnosis is made.
Therapy
The treatment of the disease is aimed at correcting the patient's motor skills. The doctor conducts training of the patient in sequential purposeful actions, if he has retained all mental functions. With a combination of apraxia with a speech disorder, the treatment will be difficult, since in this case the contact with the patient is complicated.
With this disease, the treatment regimen is selected individually in each case. The doctor prescribes physiotherapy, occupational therapy, cognitive rehabilitation and classes with a speech therapist. People who have serious neurological disorders receive psychological assistance and round-the-clock monitoring. For this, classes are held at the patient’s home with a psychologist, social workers, and if necessary, a nurse is invited to constantly care for the patient.
Prevention
It is very difficult to prevent the development of the disease, since it is closely associated with strokes. For the purpose of prevention, it is recommended to regularly exercise physically, eat right, lead a healthy lifestyle, avoid injuries and treat infectious diseases in a timely manner.