TREATMENT for apraxia

Medical Care

Diagnosis is the most important aspect of apraxia. Consequences include diminished ability of the patient to live independently; patients therefore may require additional rehabilitation or skilled nursing care. Education of the patient's family is obviously a key part of evaluation.

Patients with childhood apraxia of speech are at risk for persistent reading and spelling disorder in addition to their spoken communication difficulties. A potential benefit has been shown of an integrated phonological awareness approach to improve speech, phonological awareness, and decoding ability simultaneously.
Patients may not request physical or occupational therapy because they may be unaware of their deficits. Such therapy is important, as part of both assessment and treatment of the patient.

Medicines are not known to be effective for the treatment of ideomotor apraxia. Levodopa-carbidopa (Sinemet) and dopamine agonist medications (eg, ropinirole [Requip], pramipexole [Mirapex]), typically are not effective for corticobasal ganglionic degeneration, although they are tried frequently. Antispasticity treatments, such as baclofen (Lioresal), tizanidine (Zanaflex), and botulinum toxin (Myobloc), can be tried for patients with a clenched fist due to a useless limb. Cholinesterase inhibitors, such as donepezil (Aricept), rivastigmine (Exelon), galantamine (Razadyne), and memantine (Namenda) may be used for progressive dementia syndromes, especially Alzheimer disease.

Diet

Patients with apraxia may have difficulty knowing how or what to eat. If a patient is losing weight or nutritional deficiencies are suspected, nutritional supplements or dietary assistance might be provided.

Activity

Patients with certain types of dementia may have a high risk of falling. Patients with corticobasal ganglionic degeneration or progressive supranuclear palsy may have a high fall rate relatively early in the disease, whereas patients with Alzheimer are more likely to fall in the middle to late stages. Patients with a useless upper limb may develop a clenched painful fist that severely limits activity.