Apraxia is a movement disorder that prevents you from performing purposeful acts without having lost the physical ability or will to do so. And ataxia is a neurological disorder that results in impaired coordination of movement.

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 in different parts of the body, usually in the legs, arms, and hands, although swallowing or vision, for example, may also be affected.

Ataxia is not a disease in itself, but rather a sign that usually appears in a multitude of neurodegenerative processes that also have 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, tumoral, etc., the most frequent being 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 themselves; and the recessive ones, such as Friedreich’s ataxia, which manifest themselves if two mutations are inherited (that of the father and the mother), and moreover they are usually sporadic cases.

Apraxia: definition and types

Apraxia is a neurological disorder that is characterized by the loss of the ability to perform skillful movements and gestures with purpose , even if one has the physical ability and will to do them.

People who suffer from apraxia have great difficulty in performing required movements under verbal command or out of context; however, they can execute them spontaneously in natural situations .

There are different types of apraxia. The main ones are listed below:

Ideational apraxia

The person is incapable of ordering a series of movements or actions that lead to a specific objective , nor of creating a mental image of the act he is going to perform.

Ideomotor

It involves the inability to initiate motor skills due to an error in the sequence, amplitude, configuration and position of the limbs in space (e.g. imitating a gesture).

Constructional

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

Oral-facial, buco-lingual or buco-lingual

Inability to make purposeful 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 may sometimes be confused because they share certain aspects or clinical manifestations, such as the fact that both affect, in one way or another, the execution of certain body movements .

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

Clinical manifestation

Ataxia, as previously mentioned, is a neurological sign characterized by a loss of muscular coordination ; it is therefore a type of movement disorder and what it causes is a lack of coordination that can affect several members and extremities of the body, such as the fingers, hands, arms, legs, eye movements or the swallowing mechanism.

Apraxia, on the other hand, differs from ataxia in that it implies an inability of the subject to execute previously learned intentional movements. In this sense, in the apraxia we can see how the subject presents a lack of performance when performing a task, in spite of wanting and having the ability to provoke the necessary movements to execute it .

Causes

The causes of a neurological sign such as ataxia are different from those of an apraxia. Ataxia is generally due to lesions in the cerebellum , a structure of the brain that processes information from other brain areas, the spinal cord and sensory receptors, in order to coordinate the movements of the skeletal muscle system.

A damaged cerebellum is the main cause of the classic symptomatology of ataxias: inability to control and coordinate muscles. However, there are other causes that can produce ataxia: alcohol abuse, neurodegenerative diseases, certain drugs or diseases such as multiple sclerosis.

The causes of apraxia, however, are usually not related to lesions in the cerebellum, as is the case with ataxia. Apraxias are usually caused by damage to the parietal lobe of the dominant hemisphere (usually the left one), either by neurodegeneration or by a stroke, tumour 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 far as ataxia is concerned, there is currently no specific treatment for this condition. The health professional can recommend treatments for symptomatic control of pain or fatigue. In addition, adaptive devices can be used, such as canes or walkers, modified utensils to help eating , communication devices, etc.

The patient with ataxia may also benefit from some therapies, such as: physical therapy, to improve coordination and mobility; occupational therapy, to help the person with everyday tasks; and speech therapy, to improve speech and help swallowing better.

With regard to apraxia, it should be noted that there is also 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 the 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.

Bibliographic references:

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