Diagnostic Tests for Apraxia
Apraxia Tests: Book Excerpts
Home Diagnostic Testing
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Apraxia Diagnosis: Book Excerpts
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Diagnostic Tests for Apraxia: Online Medical Books
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for more information about the diagnostic tests for Apraxia.
APHASIA, APRAXIA, AND AGNOSIA:
DIAGNOSTIC WORKUP
(Algorithmic Diagnosis of Symptoms and Signs)
All patients should have a CBC, sedimentation rate, chemistry panel, a VDRL test, and a CT scan of the brain. The CT scan may demonstrate an infarct, a space-occupying lesion, a degenerative disease, or multiple sclerosis. If this is negative, a neurologist should be consulted before ordering MRI or a spinal tap.
If the patient presents with intermittent aphasia, apraxia, or agnosia, an EEG should be done to rule out epilepsy, and a carotid scan should be done to rule out carotid stenosis or carotid plaques with ulceration. Four-vessel angiography may need to be considered, but a neurologist should be consulted before this is done.
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Source: Algorithmic Diagnosis of Symptoms and Signs, 2003
Apraxia:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
If you detect apraxia, ask about previous neurologic disease. If the patient fails to report such disease, begin a neurologic assessment. First, take the patient’s vital signs and assess his level of consciousness. Be alert for any evidence of aphasia or dysarthria. Ask the patient if he has recently experienced headaches or dizziness. Then test the patient’s motor function, observing for weakness and tremors. Next, use a small pin or another pointed object to test sensory function. Check deep tendon reflexes for quality and symmetry. Finally, test the patient for visual field deficits.
Be alert for signs and symptoms of increased intracranial pressure (ICP), such as headache and vomiting. If you detect these, elevate the head of the bed 30 degrees and monitor the patient closely for altered pupil size and reactivity, bradycardia, widened pulse pressure, and irregular respirations. Have emergency resuscitation equipment nearby, and be prepared to give mannitol I.V. to decrease cerebral edema.
If the patient is experiencing seizures, stay with him and have another nurse notify the physician immediately. Avoid restraining the patient. Help him to a supine position, loosen tight clothing, and place a pillow or other soft object beneath his head. If the patient’s teeth are clenched, don’t force anything into his mouth. If his mouth is open, protect the tongue by placing a soft object, such as a washcloth, between his teeth. Turn the patient’s head to provide an open airway.
After completing the examination and ensuring the patient’s safety, take a history. Ask about previous cerebrovascular disease, atherosclerosis, neoplastic disease, infection, or hepatic disease. Then assess the apraxia further to help determine its type. (See Apraxia: Causes and associated findings, page 72.)
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Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Apraxia:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Perform a neurologic assessment. First, take the patient’s vital signs and assess his level of consciousness. Be alert for any evidence of aphasia or dysarthria. Then test the patient’s motor function, observing for weakness and tremors. Next, use a small pin or other pointed object to test sensory function. Check deep tendon reflexes for quality and symmetry. Finally, test the patient for visual field deficits.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Verbal Communication Difficulty:
Diagnostic Approach
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
Problemin verbal communication often presents as delay in language development orinadequate use of speech. Table72.1 describes normal sequence of receptive and expressivelanguage development.Children at high risk for problemswith verbal communication include those with cleft palate, mentalretardation, cerebral palsy, hearing loss or deafness, deprivation,or psychologic disturbance.Complete history, physical exam, anddevelopmental assessment should be performed when a child exhibitsverbal communication difficulties. Physician can listen to childrentalking in natural conversation and have them repeat specific wordsor sentences to assess use of consonants, vowels, pronouns, vocabulary,syntax, and intelligibility of speech. Communication disorder shouldbe suspected if any indications listed in Table 72.2 are observed.Children with delayed language or inadequatespeech should have their hearing tested and language and speechskills evaluated by speech-language pathologist. Children with voicedisorders should be referred to otolaryngologist or speech pathologistif voice is chronically hoarse or of poor quality, pitch is inappropriatefor age or sex, pitch brakes occur often, or voice is hypernasalor hyponasal.Child with stuttering should be referredto speech-language pathologist if parents have expressed concernabout the condition; if child has abnormal number of repetitions,hesitations, prolongations, blocks, or disruptions in natural courseof speech; or if child is concerned and becomes anxious or tenseduring speech, or avoids speaking due to fear of stuttering.
» READ BOOK EXCERPT ONLINE »
Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006
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