A case of dressing apraxia? A case study

Abstract

Dressing apraxia is defined as the condition in which automatic, spontaneous capacity for dressing is lost ( Brain, 1941 ). This case report details the rehabilitation of a 58-year-old man who required protracted ITU care for endocarditis complicated by bilateral hemispheric embolic infarcts. At presentation to the rehabilitation unit he exhibited significant visuo-perceptual changes and difficulties with dressing, domestic and community-based tasks. He developed insight into his spatial impairments and, following a period of intervention, compensated for these difficulties. However the dressing difficulties remained despite intervention. This is an unusual presentation and one that might typically be considered dressing apraxia. This case report aims to highlight the importance of considering apraxia related to dressing within a differential diagnosis of visuo-perceptual impairments. Our report suggests that there may be justification in the classification of dressing apraxia as an impairment outside the broader terms of ideomotor and ideational apraxia. It also highlights the difficulty in treating apraxia related to dressing particularly when the affected person has minimal insight into their difficulties.