eMedicine Specialties > Neurology > Behavioral Neurology and Dementia

Apraxia and Related Syndromes: Differential Diagnoses & Workup

Author: Jasvinder Chawla, MBBS, MD, MBA, Associate Professor of Neurology, Director of Neurology Residency Training Program, Director of Clinical Neurophysiology Laboratory, Assistant Director of Neurology Clerkship Program, Department of Neurology, Loyola University Medical Center
Coauthor(s): Daniel H Jacobs, MD, Associate Professor of Neurology, University of Central Florida College of Medicine
Contributor Information and Disclosures

Updated: Jan 14, 2009

Differential Diagnoses

Writer's Cramp

Other Problems to Be Considered

The differential diagnosis for ideomotor apraxia includes hemiparesis, movement disorders such as Parkinson disease and dystonia, deafferentation, hysteria, and malingering.

The differential diagnosis for corticobasal ganglionic degeneration includes Alzheimer disease, progressive supranuclear palsy, Pick disease, other frontotemporal dementias, and nonspecific progressive gliosis.

The differential diagnosis for the cause of ideomotor apraxia includes stroke, dementia, tumor, other mass lesions, CNS infection and inflammation, and multiple sclerosis.

Workup

Imaging Studies

A patient with suspected apraxia should undergo neuroimaging (either CT scan or MRI) to exclude a mass lesion and to evaluate for possible atrophy suggestive of a degenerative condition.

Histologic Findings

The histologic findings in apraxia depend on the underlying cause, ie, stroke, degenerative disease, or tumor. Specific histologic findings most often can be found in degenerative diseases. In Alzheimer disease, amyloid plaques and neuritic tangles are found. In Pick disease, Pick bodies are seen. In corticobasal ganglionic degeneration, balloon neurons with neuronal achromasia are characteristic.

More on Apraxia and Related Syndromes

Overview: Apraxia and Related Syndromes
Differential Diagnoses & Workup: Apraxia and Related Syndromes
Treatment & Medication: Apraxia and Related Syndromes
Follow-up: Apraxia and Related Syndromes
References
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References

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  3. Aboitiz F, Carrasco X, Schroter C, et al. The alien hand syndrome: classification of forms reported and discussion of a new condition. Neurol Sci. Nov 2003;24(4):252-7. [Medline].

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  14. Watson RT, Fleet WS, Gonzalez-Rothi L, Heilman KM. Apraxia and the supplementary motor area. Arch Neurol. Aug 1986;43(8):787-92. [Medline].

  15. Watson RT, Heilman KM. Callosal apraxia. Brain. Jun 1983;106 (Pt 2):391-403. [Medline].

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Further Reading

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Keywords

apraxia and related syndromes, behavioral neurology syndrome, apraxia of speech, buccofacial apraxia, callosal apraxia, conceptual apraxia, dyspraxia, ideomotor apraxia, ideational apraxia, limb apraxia, limb kinetic apraxia, magnetic apraxia, motor agnosia, oral apraxia, parectropia, disorder of voluntary movement, voluntary movement disorder, alien hand syndrome

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Contributor Information and Disclosures

Author

Jasvinder Chawla, MBBS, MD, MBA, Associate Professor of Neurology, Director of Neurology Residency Training Program, Director of Clinical Neurophysiology Laboratory, Assistant Director of Neurology Clerkship Program, Department of Neurology, Loyola University Medical Center
Jasvinder Chawla, MBBS, MD, MBA is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, American Clinical Neurophysiology Society, and American Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

Daniel H Jacobs, MD, Associate Professor of Neurology, University of Central Florida College of Medicine
Daniel H Jacobs, MD is a member of the following medical societies: American Academy of Neurology, American Society of Neurorehabilitation, and Society for Neuroscience
Disclosure: Teva Pharmaceutical Grant/research funds Consulting; Biogen Idex Grant/research funds Independent contractor; Serono EMD Royalty Speaking and teaching; Pfizer Royalty Speaking and teaching; Berlex Royalty Speaking and teaching

Medical Editor

Stephen T Gancher, MD, Adjunct Associate Professor, Department of Neurology, Oregon Health Sciences University
Stephen T Gancher, MD is a member of the following medical societies: American Academy of Neurology, American Neurological Association, and Movement Disorders Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Richard J Caselli, MD, Professor, Department of Neurology, Mayo Medical School, Rochester, MN; Chair, Department of Neurology, Mayo Clinic of Scottsdale
Richard J Caselli, MD is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, American Neurological Association, and Sigma Xi
Disclosure: Nothing to disclose.

CME Editor

Matthew J Baker, MD, Consulting Staff, Collier Neurologic Specialists, Naples Community Hospital
Matthew J Baker, MD is a member of the following medical societies: American Academy of Neurology
Disclosure: Nothing to disclose.

Chief Editor

Howard A Crystal, MD, Professor, Departments of Neurology and Pathology, State University of New York Downstate; Consulting Staff, Department of Neurology, University Hospital and Kings County Hospital Center
Howard A Crystal, MD is a member of the following medical societies: American Academy of Neurology and American Neurological Association
Disclosure: Pfizer Honoraria Speaking and teaching; Myriad Honoraria Consulting

 
 
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