Bolesti hlavy - nové možnosti léčby

MUDr. Pavel Řehulka, Ph.D.

Neurol. praxi. 2025;26(6):447-451 | DOI: 10.36290/neu.2025.021

Migraine in children and adolescents: specific features and treatment

MUDr. Hana Medřická, MBA, MUDr. Zuzana Krška Kušníriková, Ph.D., MUDr. Petra Migaľová

Neurol. praxi. 2025;26(6):457-462 | DOI: 10.36290/neu.2025.050

Migraine is a condition that occurs across all age groups. In the pediatric population, it is underdiagnosed compared to adults. Pediatric migraine has specific neurodevelopmental and clinical characteristics, and its diagnostic and therapeutic approaches differ partially from those used in adults. In this article, we aim to highlight these issues.We present some epidemiological data on migraine occurrence, migraine phenotypes in the pediatric population, diagnostic and treatment approaches, and practical insights, with a broader focus on treatment.

Management of migraine in a woman

MUDr. Radka Marková, MUDr. Halina Hevková

Neurol. praxi. 2025;26(6):465-470 | DOI: 10.36290/neu.2025.034

Migraine is a chronic neurological disease that affects 15-20 % of women of reproductive age. Migraine treatment in women involves specific approaches due to hormonal influences. Estrogens play a key role in menstrual migraine, which often occurs during the luteal phase of the cycle. Migraine is three times more common in women than in men, with differences becoming apparent after puberty. Hormonal changes, including the menstrual cycle, pregnancy and menopause, contribute significantly to the higher prevalence of migraine in women. Female gender is also a risk factor for chronic migraine and overuse headache. Pregnancy and breastfeeding place specific...

Migraine treatment in seniors and patients with cardiovascular disease

MUDr. Petr Mikulenka, PharmDr. Markéta Pitrová, MUDr. Jolana Mračková, Ph.D., prof. MUDr. Ivana Štětkářová, CSc., MHA

Neurol. praxi. 2025;26(6):472-476 | DOI: 10.36290/neu.2025.046

Migraine is a common neurological disorder that also affects seniors, despite its preva­lence decreasing with age. Even in this population, it can significantly impact quality of life and complicate the management of comorbidities. The clinical presentation of migraine in older patients often differs - attacks tend to be less frequent and milder, may be bilateral, and accompanying symptoms such as photophobia or phonophobia occur less frequently. A major diagnostic challenge is distinguishing aura without headache from a transient ischemic attack (TIA). Migraine treatment in seniors requires an individualized approach, considering pharmacokinetic and...

Resistant and refractory migraine

MUDr. Andrea Bártková, Ph.D.

Neurol. praxi. 2025;26(6):477-481 | DOI: 10.36290/neu.2025.030

The author in the article presents current definitions of resistant, refractory migraines and treatment failure in relation to recent migraine therapeutic options and their implementation in clinical practice.

Healthcare organization for patients with migraine: differences between Slovak and Czech healthcare system

MUDr. Andrea Petrovičová, PhD., MUDr. Pavel Řehulka, Ph.D.

Neurol. praxi. 2025;26(6):482-487 | DOI: 10.36290/neu.2025.029

The primary goal of healthcare for patients with headaches is to improve the quality of life. This requires recognizing headaches as a disease, improving healthcare and ensuring its easy accessibility. These conditions can be achieved by appropriate organization of the health system and increasing efficiency. The organizational model of care recommended by the consensus of the European Headache Federation and Lifting The Burden: the Global Campaign against Headache is suitable for most European countries. However, health services are structured differently in countries. In this article, we present the differences in the organization of healthcare for...

The importance of monitoring asymptomatic carriers of the TTR gene mutation in hereditary transthyretin amyloidosis - a neurologist´s perspective

MUDr. Ivan Martinka, PhD., MUDr. Alexandra Mražíková

Neurol. praxi. 2025;26(6):490-496 | DOI: 10.36290/neu.2025.074

Hereditary transthyretin amyloidosis (hATTR) is an autosomal dominant inherited disorder caused by the deposition of amyloid composed of mutated transthyretin (TTR) or its fragments. TTR amyloid preferentially accumulates in peripheral nerves and the myocardium. Involvement of the peripheral nervous system manifests with autonomic, sensory, and motor symptoms. Without treatment, the disease is relentlessly progressive, leading to death within a few years. Causal therapy can significantly slow disease progression. It is essential to initiate treatment as early as possible, since prolonged disease duration may lead to only partially reversible changes...

Altered pharmacokinetics of selected neurological drugs in patients with chronic kidney disease

Mgr. Michaela Jelínková, PharmDr. Alena Pilková,Ph.D., PharmDr. Jan Miroslav Hartinger, Ph.D.

Neurol. praxi. 2025;26(6):505-514 | DOI: 10.36290/neu.2025.065

Chronic kidney disease significantly affects the pharmacokinetics of various neurological drugs, necessitating careful dosage adjustments. Due to reduced renal clearance, drugs eliminated via the kidneys experience prolonged biological half-lives and accumulation, increasing the risk of toxicity or delaying therapeutic effects. Hypoalbuminemia leads to an increased free fraction of drugs bound to plasma proteins, further complicating accurate interpretation of therapeutic drug levels, as demonstrated with valproic acid. The article addresses the impact of impaired renal function and extracorporeal elimination methods on neurologic renally eliminated...

Ocrelizumab and treatment of multiple sclerosis during pregnancy and breastfeeding

MUDr. Jana Pavlíčková, Ph.D.

Neurol. praxi. 2025;26(6):498-504 | DOI: 10.36290/neu.2025.081

Multiple sclerosis is an autoimmune neurological disease that is very often diagnosed in women of childbearing age. Multiple sclerosis does not worsen the course of pregnancy; the risk of relapse is low during pregnancy, but increases after delivery. A key factor in the treatment of our patients is therefore pregnancy planning and therapy that stabilizes patients during pregnancy and postpartum and does not pose a risk to the fetus or newborn. Ocrelizumab (humanized anti-CD20 monoclonal antibody) administered before planned pregnancy and during lactation shows minimal transfer through the placental barrier and into breast milk, allowing according to...

Vitamin B₁₂ deficiency - a case report of subacute combined degeneration of the spinal cord in comparison with NMOSD

MUDr. Viktorie Neumannová, MUDr. Adam Váchal, MUDr. Pavel Potužník, Ph.D., MUDr. Ing. Radek Tupý, Ph.D.

Neurol. praxi. 2025;26(6):515-519 | DOI: 10.36290/neu.2025.064

Subacute combined degeneration of the spinal cord arises due to vitamin B₁₂ deficiency and belongs to the differential diagnosis of spinal cord lesions. In addition to involvement of the spinal cord tracts, vitamin B₁₂ deficiency can also lead to lesions of the peripheral nerves, optic nerves and brain. Furthermore, vitamin B₁₂ deficiency may manifest with hematological and gastrointestinal disorders. Given the findings on spinal cord MRI, demyelinating diseases, including neuromyelitis optica spectrum disorder (NMOSD), should be considered in the differential diagnosis. In cases of spinal cord lesions, a careful diagnostic...

NMOSD as a comorbidity of clinically silent Sjögren's syndrome

MUDr. Tereza Strnadová, MUDr. Dalibor Zimek

Neurol. praxi. 2025;26(6):520-526 | DOI: 10.36290/neu.2025.045

NMOSD (Neuromyelitis optica spectrum disorders) is a group of rare inflammatory autoimmune demyelinating diseases affecting most commonly the optic nerve, brainstem and spinal cord. During diagnostic process is necessary to rule out multiple sclerosis and myelin oligodendrocyte glycoprotein antibody-positive disease (MOGAD). NMOSD and MOGAD are still quite new diagnostic entities. Without treatment, NMOSD has a high risk of relapse and the possibility of permanent disability, especially in young people and those of working age, which is multiplied by its comorbidities. Part of the diagnostic process involves ruling out other neurological causes of...

Od transplantace k fSCIGZaznělo na 4. české neurologické akademii v Plzni 23.-24. října 2025

MUDr. Zuzana Zafarová

Neurol. praxi. 2025;26(6):527-530