The two types of motor apraxia.

Ideomotor and ideational apraxia are higher motor disturbances at two different levels. In ideomotor apraxia the execution of simple and complex, meaningful and meaningless movements with the orofacial musculature and/or with the limbs, is impaired in a very distinct way, as has been described in detail. The parapraxic distortions of movements occur, when the movement is required out of context. The recognition of movements and gestures is intact. In ideational apraxia, in contrast, there is a disturbance in the conceptual organization of complex actions requiring the use of various objects. The syndrome is observed already in the spontaneous behaviour of the patients. There are indications that these patients are also impaired in the recognition of actions.