Slovo úvodem

prof. MUDr. Ivan Rektor, CSc., FCMA, FANA

Neurol. praxi. 2013;14(5):223  

Neurostimulace v neurologii - úvod

prof. MUDr. Ivan Rektor, CSc., FCMA, FANA

Neurol. praxi. 2013;14(5):228  

Deep brain stimulation in Parkinson´s disease

MUDr.Marek Baláž, Ph.D.

Neurol. praxi. 2013;14(5):229-231  

Deep brain stimulation is a neuromodulation therapy of late motor complications of Parkinson´s disease in suitable patient candidates. The most widely used anatomical target for DBS is the subthalamic nucleus. Effect of stimulation is reflected by the substantial improvement of the UPDRS III score – of about 30 to 70 %. The dopaminergic medication can usually be decreased by about 50 %, thanks to good effect of the procedure on motor function of PD patients. The intensity and duration of dyskinesias is usually reduced by about 60–70 %, off states by 60 %. DBS also significantly improves the quality of life. The globus pallidum internum...

Deep brain stimulation in dystonia

doc.MUDr.Robert Jech, Ph.D.

Neurol. praxi. 2013;14(5):232-236  

Dystonia is a heterogeneous group of syndromes manifested by cramp-like involuntary movements or postures of one or more body parts. Some cases are refractory to drug therapy. This makes us consider bilateral deep brain stimulation of the internal pallidus (DBS GPi) which promises significant improvement mainly in disabling generalized and segmental daystonic syndromes. Patients with cervical dystonia with secondary resistance to botulinum toxin may benefit from this treatment as well. Despite the absence of straightforward indication or exclusion criteria there are certain prognostic markers suggesting the future individual clinical effect...

Deep brain stimulation in the context of neurostimulation treatment of epilepsy

prof.MUDr.Ivan Rektor, CSc., FCMA, FANA

Neurol. praxi. 2013;14(5):237-239  

An epileptic seizure is a manifestation of synchronization and spread of abnormally organized rhythmic elec¬trical activity of the brain. Neurostimulation techniques modulate large-scale distributed neuronal networks, including those involved in epileptic processes. Vagus nerve stimulation and deep brain stimulation (DBS) of the anterior nucleus of the thalamus (ANT) are routinely utilized in clinical practice. Both are effective palliative methods in the treatment of pharmacoresistant epilepsy. Further stimulation targets are being tested; as yet, smaller cohorts of patients with DBS of the subthalamic nucleus, caudate nucleus, centrum...

Vagus nerve stimulation and its place in current clinical practice

prof.MUDr.Robert Kuba, Ph.D.

Neurol. praxi. 2013;14(5):240-243  

Vagus nerve stimulation (VNS) currently has a firm place in the treatment algorithm in patients with pharmacoresistant epilepsy. VNS is indicated in patients with pharmacoresistant focal as well as generalized epilepsy in whom resection epilepsy surgery is not indicated. Clinical experience shows that there is significant improvement in the quality of life in two-thirds of patients treated with VNS. Approximately 5 % of patients are completely seizure-free in the long term. Side effects of stimulation, resulting in termination of stimulation, and surgical complications occur in about 2 % of patients.

Neurostimulation metods in the treatment of chronic pain

MUDr.Jitka Fricová, prof.MUDr.Richard Rokyta, DrSc.

Neurol. praxi. 2013;14(5):244-246  

This article describes the neurostimulation methods used in the treatment of chronic intractable pain. There are two types of neurostimulation methods-invasive and noninvasive. For all methods are briefly described their physiological and pathophysiological mechanisms, technical parameters of stimulation and treatment indications.Invasive methods are: peripheral nerve stimulation (PNS), spinal cord stimulation (SCS), Motor Cortex Stimulation. (MCS) Non-invasive stimulation methods are: transcutaneous electrical nervous stimulation (TENS), repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS)....

Peripheral neuropathies in malignancies

prof.MUDr.Zdeněk Ambler, DrSc.

Neurol. praxi. 2013;14(5):247-251  

Peripheral neuropathies in a context of systemic malignancy may have a different cause and can manifest in various stages of development of malignancy. They can be a direct effect of the primary malig nancy, a paraneoplastic syndrome, or a treatment complication. Malignant neoplasms may infiltrate or compress peripheral nerves or roots, causing various sensory and motor symptoms. Paraneoplastic syn dromes are rare, but they can precede a manifestation of the cancer itself. The most common is subacute sensory neuronopathy, sensorimotor neuropathies are less common. Neuropathies may also be an indirect consequence of a dysimmune mechanism, for...

Neuroinfection and intensive care

doc.MUDr.Luděk Rožnovský, CSc.

Neurol. praxi. 2013;14(5):252-256  

Clinical picture of serious central nervous infections include disturbance of consciousness, seizures or local neurological signs. Purulent meningitis, encephalitis and brain abscesses are the most frequent etiology. Rapid diagnostic and empiric therapy is necessary especially in patients with purulent meningitis and herpetic encephalitis. Delay of causal therapy increase risk of serious course or death of the patient.

Interferon-β biological activity; monitoring of the treatment effect in multiple sclerosis patients in the Czcech republic

MUDr.Eva Meluzínová, MUDr.Jana Libertínová, Mgr.Miroslav Zajac, MUDr.Václav Maťoška

Neurol. praxi. 2013;14(5):258-261  

Interferons-β are used as a first-line treatment in patients with multiple sclerosis. However, up to half of patients develop neutralising antibodies (NAbs). On long-term follow up, NAbs positive patients show higher disease activity both clinically and on MRI. WHO recommends cythopathogenic effect evaluation as a standard method for Nabs assessment. Especially in high serum titers, NAbs persist for long time periods and significantly lower the biological efficacy of interferons-β. Myxovirus resistance protein A (MxA) synthesis is induced exclusively by interferons-β. Therefore, MxA assessment helps to evaluate residual biological...

Pituitary adenoma: results of surgical treatment with transnasal endoscopic technique

MUDr.Radim Lipina, Ph.D., MUDr.Petr Matoušek, Ph.D., MUDr.Tomáš Krejčí, MUDr.Tomáš Hrbáč, MBA, doc.MUDr.Pavel Komínek, Ph.D., MBA

Neurol. praxi. 2013;14(5):262-266  

Transnasal endoscopic approach represents a novel, mini-invasive surgical method for removing sellar tumours. The paper presents five-year experience with surgery for pituitary adenomas using this technique. From March 2007 to April 2012, 101 surgeries in 99 patients with the diagnosis of pituitary adenoma were carried out at the Department of Neurosurgery of the Ostrava Teaching Hospital. The surgeries were performed using the transnasal approach, in collaboration with an otorhinolaryngologist, under endoscopic control. Radical resection was achieved in 81.8 % of patients. There was no mortality in the group; complications occurred in 5.9...

Transverse myelitis as the only manifestation of neuroborreliosis

MUDr. Alena Meleková, MUDr. Ján Latta, doc. MUDr. Edvard Ehler, CSc., MUDr. František Sedláček, MUDr. Milan Mrklovský

Neurol. praxi. 2013;14(5):267-269  

The etiology of acute transverse myelitis (ATM) is in most cases parainfectious, less frequently is ATM caused by demyelinating disorders such as multiple sclerosis. The origin can be also infectious, ischemic or idiopathic, but as the only manifestation of neuroborreliosis it represents less than 5% of all cases. The authors present a case report of 62-year old woman, in whom a red exanthema appeared. After 3 weeks she developed radicular pain in lower thoracic and lumbal region radiating along ribs. Subsequently sensory impairment below the Th7 level, sphincter dysfunction and mild spastic paraparesis appeared. In cerebrospinal fluid changes...

Profesor Zdeněk Ambler - in memoriam

MUDr. Jan Hromada, MUDr. Jiří Polívka, CSc.

Neurol. praxi. 2013;14(5):270  

The molecular genetic and biochemical aspects of neurogenetic disorders

doc.MUDr.Ján Chandoga, CSc., MUDr.Petra Jungová, RNDr.Katarína Kolejáková, RNDr.Robert Petrovič, PhD., MUDr.Juraj Štofko, MBA

Neurol. praxi. 2013;14(5):328-332  

Diseases caused by molecular genetic pathology of structural constituents of nervous system – part 2 In this paper we present selected neurogenetic diseases affecting the basal ganglia, spinocerebellar disorders and diseases associated with disabilities of motor and peripheral neurons. We describe Huntington’s, Parkinson’s, Friedreich’s disease, spinocerebellar ataxias, amyotrophic lateral sclerosis, spinal and bulbar muscular atrophy, spinal muscular atrophy, hereditary spastic paraplegias, Charcot-Marie- -Tooth disease type 1A and hereditary neuropathy with liability to pressure palsy. We are dedicated to the incidence,...