Disturbances in body perception after stroke (Apraxia)
Apraxia
Mr. A had a stroke two months ago. He was lightly paralysis of the right leg, moderate paralysis of right arm, and some problems with word retrieval. He found it difficult to manage even the simplest practical tasks. When he was brewing coffee, he was standing and lifting the coffee filter up and down the maker, without taking coffee into it. When he was eating, he kept the cutlery just like a three-year practicing in eating even for the first time, in spite of with the non-paralyzed left hand.
Apraxia is the failure of the execution of voluntary, goal-oriented actions, not due to paralysis, sensory loss or changes in the musculoskeletal system. When the patient to perform an action, he or she has problems with the order or the selection of parts of the compound action. The patient may have difficulty getting started, make frequent stops up and repeat the same movement several times, and he has difficulty using utensils. The condition is seen most often by injury in the left hemisphere, and patients sometimes have concomitant difficulty speaking or understanding (aphasia).
Apraxia can be examined by asking the patient to demonstrate how he performs an everyday activity such as combing hair or brushing teeth. Alternatively, one can demonstrate the correct movement and see if the patient can imitate.
Room-directional difficulties
Mrs. B had a stroke of half a year ago. In the acute phase, she had left-sided paralysis, but later had the motor skills come up a lot, and she had only to lean on a cane when she walked. Still, it was difficult for her to get dressed. It was like she was not "found their way" into a sweater or jacket, she was unable to control the arms and head into the correct slots. If the garment at all finished, it was often vrangt or back to front. She had several times passed away in places where she was well known, but she was not forgetful or disoriented.
Room-directional difficulties mean difficulties of assembling parts into a whole and to take actions in space. The patient may have difficulty with the relationship between the body and the surrounding room, with a body part relation and keeping track of right and left. Problems with judging distance can prove in that they fail to grasp the glass standing on the table, or that they do outside of the coffee cup. They can be completely or partially out of the chair; they may have difficulty recognize themselves in the neighborhood, and they cannot understand a piece of clothing as a three-dimensional structure. Problems with relationships between objects can prove such. In that they fail to assemble the parts of a coffee maker, even if this is familiar.
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