How a Stroke Affects Spatial Abilities

Ideomotor Apraxia

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A stroke survivor can experience a variety of long term handicaps that interfere with daily life. Ideomotor apraxia can occur as a result of a stroke that affects the parietal lobe of the brain.

Ideomotor apraxia is one of the most challenging stroke effects to overcome. It affects a stroke survivor's ability to carry out simple motor tasks, yet is not related to weakness or loss of sensation. In fact, ideomotor apraxia is a more complex problem stemming from a diminished ability to integrate spatial awareness and coordination of movement.


Ideomotor apraxia (IMA), is also known as voluntary-automatic dissociation. It is a neurological disorder characterized by the inability to perform a variety of physical movements. Things that we typically consider simple motor tasks, such as using a hammer or waving goodbye, can become clumsy and confusing for a stroke survivor suffering with ideomotor apraxia.

Even when a stroke survivor has already previously developed experience in properly using an object or performing a skilled task, he or she is unable to mimic the movement, such as motion of the hammer itself.


The parietal lobe controls the ability to read, write and understand spatial concepts. A stroke of the parietal lobe is the most common cause of ideomotor apraxia. In fact, the region of the parietal lobe which is located near the back and top of the head, above the ears is specifically responsible for this problem.

Other neurological conditions that impair the parietal lobe can also produce ideomotor dysfunction. These include:


People who have ideomotor apraxia may exhibit symptoms that include frustration, depression and expressions of profanity. One of the most obvious symptoms of ideomotor apraxia is the inability to pantomime the use of a tool or object.

Other symptoms may also include:

  • Unable to make physical gestures or motions when asked
  • Unable to imitate a physical gesture, such as waving
  • Unable to hold an object as it is intended
  • Mistaking one object for another and using the objects incorrectly

Most of the time, these problems are apparent with very simple tasks, such as brushing teeth, buttoning buttons, or shaving. More sophisticated physical skills, such as mending or cooking, may be almost impossible to carry out.


The diagnosis of ideomotor apraxia involves a thorough neurological examination, which includes evaluation of language, cognition (thinking skills) and motor strength. 

Your doctor may order some diagnostic tests to help with the diagnosis. These tests may include any of the following:

  • CT scan of the brain
  • MRI scan of the brain
  • Electroencephalogram (EEG)
  • Lumbar puncture (a test which evaluates the health of spinal fluid)

These medical tests can help identify a specific problem in the brain that could be responsible for the symptoms- such as a stroke, a brain tumor, or an infection.

Medical Management

The treatment of ideomotor apraxia involves physical therapy, speech therapy and occupational therapy. The outcome of treatment largely depends on the underlying cause of the ideomotor apraxia and the severity of the brain injury to the parietal lobe and surrounding regions.

Many conditions, such as stroke and head trauma, tend to improve over time. Other conditions, such as a brain tumor or an infection, may improve after medical or surgical treatment. Other causes of ideomotor apraxia, such as Alzheimer's disease and other types of dementia, tend to worsen over time.


People who are dealing with apraxia are often unable to live independently because of trouble with functioning on a day-to-day basis.

Possible complications of ideomotor apraxia include:

  • Learning problems
  • Social isolation
  • Lowered self-esteem
  • Depression
  • Frustration

A Word From Verywell

You may have expected a physical handicap if you or your loved one has had a stroke or head trauma. However, many neurological conditions cause cognitive problems as well. Problems with spatial function and spatial awareness pose a special challenge when it comes to independent living. Often, people who have ideomotor apraxia are unaware that they have a handicap, and may even neglect a part of their own body.

If you are a caregiver of a person who has ideomotor apraxia, be sure to seek support and resources as you navigate recovery and daily life.

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