These neurological alterations can be confused, but it is convenient to know how to distinguish them.
Apraxia is a movement disorder that prevents intentional acts from being carried out without losing the physical ability or the will to do so. And ataxia is a neurological disorder that causes a decrease in coordination of movements.
Next, we will see what are the main differences between apraxia and ataxia with respect to their causes, clinical symptoms and the indicated treatment.
Ataxia: definition and types
Ataxia is a neurological disorder that affects the nervous system and causes a decrease in the ability to coordinate movements. Affected people have problems coordinating the muscles of different parts of the body, generally in the legs, arms and hands, although it 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 occur with other types of conditions. There are two types of ataxias: the primary ones are degenerative and almost always of genetic origin; and the secondary ones, whose origin can be diverse, such as metabolic, infectious, tumor, etc., the most frequent being the ataxia caused by alcohol.
On the other hand, in the group of primary ataxias and according to their hereditary form, two more large blocks can be described: the dominant ones, whose origin must be a single genetic mutation for the symptoms to manifest; and recessive ones, such as Friedreich’s ataxia, which manifests itself if two mutations are inherited (that of the father and the mother), and they are also usually sporadic cases.
Apraxia: definition and types
Apraxia is a neurological disorder that is characterized by the loss of the ability to carry out dexterous movements and gestures with purpose, while still having the physical ability and will to do them.
People with apraxia have great difficulty performing required movements under a verbal command or out of context; however, they can perform them spontaneously in natural situations.
There are different types of apraxias. The main ones are listed below:
The person is unable to order a series of movements or actions that lead to a specific goal, or to create a mental image of the act that is going to be carried out.
It involves the inability to start motor skills due to an error in the sequence, amplitude, configuration and position of the limbs in space (for example, imitating a gesture).
Difficulties organizing actions in space, such as writing or drawing.
Bucofacial, bucolingual or bucco linguofacial
Inability to perform intentional movements with 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 because they share certain aspects or clinical manifestations, such as the fact that both affect, in one way or another, the performance of certain body movements.
However, as we will see below, there are notable differences between ataxia and apraxia, such as the causes that provoke them, the symptoms and clinical signs or the treatment indicated for each of them.
Ataxia, as we have discussed previously, is a neurological sign characterized by a loss of muscle coordination ; is, therefore, a type of movement disorder and what it causes is a lack of coordination that can affect various limbs and extremities of the body, such as fingers, hands, arms, legs, eye movements or the mechanism of swallowing.
For its part, apraxia differs from ataxia in that it implies an inability of the subject to execute previously learned intentional movements. In this sense, in apraxia we can see how the subject shows a lack of performance when performing a task, despite wanting and having the ability to provoke the movements necessary to perform it.
The causes of a neurological sign such as ataxia are different from those of apraxia. Ataxia is generally due to lesions in the cerebellum, a brain structure that is responsible for processing information that comes from other brain areas, the spinal cord and sensory receptors, in order to coordinate the movements of the brain. skeletal muscular system.
A damaged cerebellum is the main cause that causes the classic symptomatology of ataxias: inability to control and muscle coordination. However, there are other causes that can cause ataxia: alcohol abuse, neurodegenerative diseases, certain drugs or diseases such as multiple sclerosis.
The causes of apraxias, however, are not usually related to lesions in the cerebellum, as is the case with ataxia. Normally, apraxias are caused by damage to the parietal lobe of the dominant hemisphere (usually the left), either due to neurodegeneration or due to a cerebral infarction, tumor or trauma.
In some cases, apraxias can also be caused by lesions in 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.
As for ataxia, there is currently no specific treatment for this condition. The healthcare professional may recommend treatments for symptomatic control of pain or fatigue. In addition, adaptive devices such as canes or walkers, modified utensils to aid eating, communication devices, etc. can be used.
The ataxia patient can also benefit from some therapies, such as: physical therapy, to improve coordination and mobility; occupational therapy, to help the person in daily life tasks; and speech therapy, to improve speech and help swallow better.
Regarding apraxia, it should be noted that there is no specific treatment indicated for this disorder. The therapies that are usually recommended are physiotherapy, occupational therapy and neuropsychological rehabilitation that includes the restoration or compensation of altered capacities, also taking into account those that are preserved.
The neuropsychological approach to apraxia should include the following aspects: facilitate motor learning, work with the patient on tasks without errors, provide verbal and sensory feedback, and try to work in real environments.
- 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.