The main differences between ataxia and apraxia

Apraxia is a movement disorder that prevents you from performing intentional acts without losing your physical ability or your will to do so. And ataxia is a neurological disorder that results in decreased coordination of movements.

Then we will see what they are the main differences between apraxia and ataxia with regard to its causes, clinical symptoms and treatment indicated.

    Ataxia: definition and type

    Ataxia is a neurological disorder that affects the nervous system and causes a decrease in the ability to coordinate movements. Affected people find it difficult to coordinate muscles in different parts of the body, usually in the legs, arms, and hands, although this can also affect swallowing or vision, for example.

    Ataxia is not a disease in itself, but a sign that usually appears in a multitude of neurodegenerative processes that also work with other types of conditions. There are two types of ataxias: primary, they are degenerative and almost always of genetic origin; and the secondary ones, the origin can be diverse, such as metabolic, infectious, tumoral, etc., being the most frequent ataxia caused by alcohol.

    On the other hand, in the group of primary ataxias and according to the hereditary form they have, two larger blocks can be described: the dominant ones, the origin must be a single genetic mutation for the symptoms to appear; and recessive, such as Friedreich’s ataxia, which occurs if two mutations are inherited (that of the father and the mother), and are also often sporadic.

      Apraxia: definition and type

      Apraxia is a neurological disorder characterized by loss of the ability to perform skillful movements and targeted gestures, Despite the physical ability and willingness to do them.

      People who suffer from apraxia have great difficulty in performing the movements required under a verbal command or out of context; But, yes they can run spontaneously in natural situations.

      There are different types of apraxia. Here are the main ones:

      Ideational apraxia

      The person is unable to order a series of movements or actions leading to a specific goal, Nor to create a mental image of the act he performed.

      Ideomotor

      It involves the inability to implement motor skills by an error in the sequence, amplitude, configuration and position of the limbs in space (For example, imitate a gesture).

      constructive

      Difficulties in organizing actions in space, such as writing or drawing.

      Oral-facial, bucolinguistic or linguofacial hole

      Inability to make intentional movements with certain parts of the face, including the cheeks, lips, tongue, and eyebrows.

      Differences between ataxia and apraxia

      Apraxia and ataxia are two disorders that affect the nervous system and can sometimes be confused with each other to share certain clinical aspects or manifestations, such as the fact that both affect, in one way or another, the performance of certain bodily movements.

      However, as we will see below, there are some notable differences between ataxia and apraxia, such as the causes that provoke them, the clinical symptoms and signs, or the treatment indicated for each of them.

      clinical manifestation

      Ataxia, as discussed above, is a neurological sign that is characterized by loss of muscle coordination; it is therefore a type of movement disorder and what it causes is a lack of coordination which can affect various limbs and members of the body, such as fingers, hands, arms, legs, movements eyepieces or the mechanism of movement.

      On the other hand, apraxia differs from ataxia in that it involves an inability of the subject to perform intentional movements previously learned. In this sense, in apraxia we can see how the subject has a lack of performance when performing a task, despite the desire and ability to induce the movements necessary to perform it.

      the causes

      The causes that give rise to a neurological sign such as ataxia are different from those of apraxia. Ataxia is usually due to injury to the cerebellum, A structure of the brain that is responsible for processing information from other regions of the brain, spinal cord, and sensory receptors, in order to coordinate movements of the skeletal muscle system.

      A damaged cerebellum is the main cause of the classic symptoms of ataxia: the inability to control and coordinate the muscle. However, there are other causes that can cause ataxia: alcohol abuse, neurodegenerative diseases, certain medications, or diseases like multiple sclerosis.

      However, the causes of apraxia are usually not related to damage to the cerebellum, as is the case with ataxia. Apraxia usually results from damage to the parietal lobe of the dominant hemisphere. (Usually left), either due to neurodegeneration, or due to stroke, tumor, or trauma.

      In some cases, apraxia can also be caused by injury to other areas of the brain, such as the premotor cortex (responsible for motor planning and sequencing, among other functions), the frontal cortex, or the corpus callosum.

        treatment

        As for ataxia, to date there is no specific treatment for this condition. The healthcare professional may recommend treatments for the symptomatic control of pain or fatigue. Outraged, adaptive devices, such as trekking poles or walkers, modified utensils can be used to help with eating, Communication devices, etc.

        The patient with ataxia may also benefit from certain therapies, such as: physiotherapy, to improve coordination and mobility; occupational therapy, to help the person with the tasks of daily living; and speech therapy, to improve speech and help you swallow better.

        Regarding apraxia, it should be noted that there is no specific treatment indicated for this disorder. The therapies usually recommended are physiotherapy, occupational therapy and neuropsychological rehabilitation which includes the restoration or compensation of deficient capacities, also taking into account those which are preserved.

        The neuropsychological approach to apraxia it should include the following aspects: facilitating motor learning, working with the patient on error-free tasks, providing verbal and sensory feedback, and trying to work in real environments.

        Bibliographical references:

        • Ardila, A. (2015). Kinetic, ideomotor, ideational and conceptual apraxia. Journal of Neuropsychology, Neuropsychiatry and Neurosciences, Vol. 15, Nº1, pp. 119-139.
        • Manto, M. and Marmolino, D. (2009). Cerebellar ataxias. Current Opinion in Neurology, 22 (4), 419-429.

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