Slovo úvodem

prof. MUDr. Ivan Rektor, CSc.

Neurol. praxi. 2017;18(4):223  

Neurosonologie

prof. MUDr. David Školoudík, Ph.D., FESO – editor hlavního tématu

Neurol. praxi. 2017;18(4):228 | DOI: 10.36290/neu.2017.090  

Atherosclerotic plaque evaluation in the carotid arteries by duplex sonography

MUDr. Petra Kešnerová

Neurol. praxi. 2017;18(4):229-232 | DOI: 10.36290/neu.2017.003  

Aterosclerosis is chronic degenerative disease leading world death rates. One of the most affected areas are carotid arteries inwhich aterosclerotic plaque progression belongs to the most important causes of ischaemic stroke. Duplex sonography is methodwidely available and safe enabeling realiable diagnostic of carotid arteries aterosclerosis. For stenosis quantification it is recommendedto apply multiparametric approach using criteria of direct and indirect sonographic diagnostic, moreover, recent researchfocuses on risk classification of aterosclerosis plaques (mainly detection of neovascularization, high lipid content, intraplaquehemorrhage, necrosis,...

Detection and evaluation of vertebral arterial stenoses

MUDr. Ondřej Škoda, Ph.D.

Neurol. praxi. 2017;18(4):233-237 | DOI: 10.36290/neu.2017.091  

Color duplex sonography, performed according to exact protocol, is a suitable and accurate imaging method of first choice forthe detection and evaluation of vertebral arterial stenoses. In this overview article we offer detailed methodology of examination,detection of direct and indirect signs of the stenosis and classification of hemodynamic parameters, including reference valuesfrom our own research. We also briefly comment clinical importance of findings in vertebral arteries and their position in thediagnostic and therapeutic algorhitm for patients with vertebrobasilar ischemia.

Detecting microemboli with transcranial Doppler

prof. MUDr. David Školoudík, Ph.D., FESO

Neurol. praxi. 2017;18(4):238-242 | DOI: 10.36290/neu.2017.092  

Transcranial Doppler (TCD) is a method of choice for detecting embolism into the cerebral vascular bed. This test is indicatedin patients with a risk of embolism in order to identify and locate the source of embolism; to select patients with a higher riskof embolic and/or thromboembolic ischaemic stroke; to adjust or monitor the efficacy of antithrombotic treatment; in patientsundergoing interventional procedures with an increased risk of embolism; or to identify divers with a higher risk of decompressionsickness. Given the different parameters for adjusting the TCD device and various characteristics used to detect emboli, aninternational consensus...

Diagnosing brain death using transcranial Doppler and transcranial duplex sonography

prof. MUDr. David Školoudík, Ph.D., FESO

Neurol. praxi. 2017;18(4):244-247 | DOI: 10.36290/neu.2017.093  

In 2014, transcranial Doppler (TCD) / colour-coded duplex sonography (TCCS) was included among auxiliary methods for detectingcerebral circulatory arrest when determining brain death in the Czech Republic. The mainstay of diagnosing cerebral circulatoryarrest is the evaluation of haemodynamic parameters in the intracranial arteries, i.e. flow direction, flow velocities, and pulsatilityand/or resistance indexes. The article describes the methodology for detection of cerebral circulatory arrest using TCD and TCCSwhich is based on the methodology of the Neurosonological Committee of the Czech Neurological Society of the Czech MedicalAssociation of Jan...

Musculoskeletal ultrasound in neurology

MUDr. Martin Kuliha

Neurol. praxi. 2017;18(4):248-252 | DOI: 10.36290/neu.2017.018  

Musculoskeletal (MSK) ultrasound is used to visualize the structures of the musculoskeletal system, i.e. muscles, tendons, joints,bones, peripheral nerves, and vessels. In the last two decades, there have been a growing number of publications and studiesdemonstrating the applicability of ultrasound in diagnosing various neurological diseases. An equally important field where MSKultrasound diagnosis can be utilized is interventional neurology procedures – local peripheral nerve anaesthesia, local nerve blocks,vessel puncture, lumbar puncture, and muscle biopsy. Ultrasonography is a rapid, widely available, relatively inexpensive, non-invasive,and...

PEGylated interferon beta-1a: a novel interferon in treating multiple sclerosis

MUDr. Pavel Hradílek, Ph.D.

Neurol. praxi. 2017;18(4):253-255 | DOI: 10.36290/neu.2017.094  

Another drug for relapsing-remitting multiple sclerosis (MS) has been introduced into the market in recent months. It is the socalled“PEGylated” interferon beta-1a. It is the original interferon beta-1a molecule, which has been known in the treatment of MSfor two decades, but has newly been bound to a molecule of polyethylene glycol (PEG), which provides it with some propertiesimproving the overall profile of the original interferon molecule. The article summarizes the profile of efficacy on clinical andradiological parameters and the safety profile of the drug established by the pivotal clinical trial ADVANCE as well as by its extensionstudy,...

Escalation vs. induction therapy in multiple sclerosis

MUDr. Marek Peterka

Neurol. praxi. 2017;18(4):256-260 | DOI: 10.36290/neu.2017.095  

A great progress has been made in the treatment of relapse-remitting multiple sclerosis in the last couple years. The arrival of newhighly efficient drugs rises discussion about choosing the right strategy, how to treat patients with MS. It is generally well known,that the key to successful treatment is the early initiation. That gives the basis to two main opinions on which kind of therapyto choose for each patient. That is the purpose of this article, which focuses deeply on the concepts of escalation and inductiontherapy of MS using the new drugs.

Immune-mediated necrotizing myopathy

MUDr. Tomáš Kalous, prof. MUDr. Josef Zámečník, Ph.D.

Neurol. praxi. 2017;18(4):261-264 | DOI: 10.36290/neu.2017.096  

Immune-mediated necrotizing myopathy is considered to be one of the idiopathic inflammatory myopathies. It is characterised byan acute onset of limb girdle weakness with widespread necrosis and regeneration of the myofibrils with minimal inflammatoryinfiltrates. Some patients have myositis-specific antibodies. Combined immunosupression is used for treatment but the responseis often poor with relapses.

Functional basal ganglia interconnection

MUDr. Miroslav Vaštík, MUDr. Kateřina Menšíková, Ph.D., MUDr. Sandra Kurčová,, MUDr. Michaela Kaiserová, Ph.D., MUDr. Zuzana Matejčíková, prof. MUDr. Petr Kaňovský, CSc.

Neurol. praxi. 2017;18(4):266-270 | DOI: 10.36290/neu.2017.097  

The circuits of basal ganglia support a wide range of sensorimotor, cognitive and emotional- motivational brain functions. A mainrole of the basal ganglia is a learning and selection of the most appropriate motor and behavioral programs. The internal functionalorganization of the basal ganglia is important for selection mechanisms. Development of basal ganglia and cerebellum takesplace over an extended period of time, in human spanning almost two decades. Factor that affect the normal development ofthe brain affect the functions of both structures. An important issue for future research might be the more precise determinationof the contribution of...

Treatment with the monoclonal antibody alemtuzumab: effect on the manifestation of thyroid disorders

prof. MUDr. Petr Vlček, CSc., RNDr. Dana Nováková

Neurol. praxi. 2017;18(4):271-273 | DOI: 10.36290/neu.2019.034  

Alemtuzumab is a humanized monoclonal antibody directed against the CD52 surface marker that is expressed on the cell surfaceof immune cells. This antibody induces a rapid and long-lasting removal of lymphocyte populations from the circulation. Treatmentwith alemtuzumab is particularly used in patients with multiple sclerosis (MS). In those with the relapsing-remitting form ofMS, it significantly reduces the risk of relapse and improves their health condition. This antibody is also used in the treatment ofpatients with chronic lymphocytic leukaemia and in kidney transplantation. Alemtuzumab has an effect on immune functions. Inpatients treated with...

Long-term treatment of RLS and PLMS with a positive influence on comorbidities

MUDr. Richard Plný

Neurol. praxi. 2017;18(4):274-278 | DOI: 10.36290/neu.2017.037  

Signs of restless legs syndrome (RLS) and periodic limb movement syndrome (PLMS) represent frequent complaints in generaland neurological practice. The prevalence in a broad population is about 10 %. These signs can be overlooked paradoxically fortheir miscellaneous nature (burning, tingling, twitching, pain in legs etc.) and a different intensity. The typical restlessness in thelower limbs alleviated by a motion is mentioned by a part of the patients. Essential is an occurrence of troubles in the eveningmainly before sleep and an improve by the movement. A bed partner testimony of the limbs movement during a sleep can alsobe helpfull in determining...

Mechanical thrombectomy after the standard time window

MUDr. Ing. David Černík, MBA, MUDr. Andrea Prcúchová, MUDr. Filip Cihlář, Ph.D, doc. MUDr. Daniel Šaňák, Ph.D., FESO

Neurol. praxi. 2017;18(4):279-282 | DOI: 10.36290/neu.2017.098  

Introduction: Mechanical thrombectomy is recommended standard treatment of occluded large cerebral artery within first 6hours since stroke onset. Beyond this standard therapeutic time window, thrombectomy may be beneficial in strictly selectedpatients only and upper treatment time limit has been still unknown. The aim was to document a positive clinical effect of thrombectomyperformed after 14 hours since stroke onset.Methods: We describe a case of 73 y/o female, who presented with sudden severe left-sided hemiparesis at home. Shewas admitted to the stroke center after eleven hours after stroke onset with severe and fluctuating hemiparesis. AdmissionCT...

Musculoskeletal ultrasound in neurology

prof. MUDr. Eva Kubala Havrdová, CSc.

Neurol. praxi. 2017;18(4):287-290 | DOI: 10.36290/neu.2017.100  

The role of B lymphocytes in the pathogenesis of multiple sclerosis is undoubted any more. The research of last years has beenrecently corroborated by three successful phase III clinical trials with ocrelizumab, a humanized monoclonal antibody againstCD20 molecule which is a marker of B lymphocytes. The spectrum of most effective drugs for remitting phase of multiple sclerosisis broadened by a drug with novel mechanism of action. The proof of the effect of this drug in primary progressive multiplesclerosis where no treatment existed up to now represents an important progress.

Vojtova reflexní lokomoce

MUDr. Jan Vacek, Ph.D., doc. MUDr. Alois Krobot, Ph.D.

Neurol. praxi. 2017;18(4):283-284