Slovo úvodem

Ivan Rektor

Neurol. praxi. 2020;21(1):3  

Dystonie

doc. MUDr. Marek Baláž, Ph.D.

Neurol. praxi. 2020;21(1):11  

Classification and general differential diagnostic approach to dystonic syndromes

doc. MUDr. Matej Škorvánek, PhD.

Neurol. praxi. 2020;21(1):12-14 | DOI: 10.36290/neu.2020.020  

Dystonia and dystonic syndromes present a heterogeneous group of disorders and may pose a major differential-diagnostic challenge in the routinne clinical practice. This manuscript discusses the basic pragmatic approach to classification and differential diagnosis of dystonic syndrome.

Oral pharmacotherapy of dystonia

MUDr. Pavel Filip, Ph.D., doc. MUDr. Marek Baláž, Ph.D.

Neurol. praxi. 2020;21(1):15-18 | DOI: 10.36290/neu.2020.021  

Despite the long history and relatively high use in the clinical practice, oral drugs in the therapy of dystonia are associated with considerable limitations. This review summarizes the options in oral therapy of acute drug-induced dystonia and chronic dystonic syndromes with various drug groups as anticholinergics, antidopaminergic agents, baclofen, benzodiazepines and others. It describes the basic posology, adverse effects and risks, emphasizing the need for individualised approach. In addition to the lacking support in relevant randomized clinical trials, the review underlines the mere symptomatic, non-curative character of the effect and the absence...

Botulinum toxin A in the treatment of dystonia

MUDr. Lenka Hvizdošová, MUDr. Pavel Otruba, MBA, MUDr. Martin Nevrlý, Ph.D., prof. MUDr. Petr Kaňovský, CSc.

Neurol. praxi. 2020;21(1):21-26 | DOI: 10.36290/neu.2020.022  

Botulinum toxin A has been used in the treatment of dystonia since the late 1980s and is the most effective method of treating focal and segmental dystonia, but has also been successfully used in the treatment of other neurological diseases manifesting with involuntary muscle contractions or muscular hypertonicity. The paper presents a summary of current knowledge about dystonia - phenomenology, pathophysiology, clinical picture, classification, and possibilities of therapeutic use of botulinum toxin A with a focus on the treatment of the most common forms of dystonia.

Deep brain stimulation in the treatment of dystonia

doc. MUDr. Marek Baláž, Ph.D., MUDr. Zuzana Košutzká, PhD., doc. MUDr. Jan Chrastina, Ph.D.

Neurol. praxi. 2020;21(1):27-30 | DOI: 10.36290/neu.2020.009  

Deep brain stimulation (DBS) is an established treatment method in cases of dystonia that are not responding to peroral medication and/or targeted botulinum toxin therapy. The most frequently used surgical target for electrode insertion is internal part of globus pallidum (GPi). Young patients with short disease duration benefit most from this surgical method. Cases of isolated dystonia, generalised dystonia with phasic elements or tardive dystonia appear to respond most to DBS GPi. Many of the double-blind clinical studies show improvement of not only motor, but also non-motor symptoms of dystonia. Predictive factors for successful DBS in dystonia...

Long term efficacy of ocrelizumab on MRI parameters in multiple sclerosis patients

MUDr. Pavel Hradílek, Ph.D.

Neurol. praxi. 2020;21(1):31-34 | DOI: 10.36290/neu.2020.031  

Multiple sclerosis (MS) is a long term inflammatory and neurodegenerative disease with variable course. Ocrelizumab, a humanized monoclonal antibody that targets CD20 receptor on B-lymphocytes and leads to depletion of these cells, represents a new drug available for treatment of MS. The rate of brain atrophy progression, which significantly correlates with neurological disability, and possibility of its deceleration by treatment, is nowadays one of the most important aspects of MS patients´ management. Magnetic resonance imaging is a very important part of monitoring of MS treatment. This review describes a long term efficacy of ocrelizumab on magnetic...

Multiple sclerosis secondary progressive form - diagnostic and treatment options

doc. MUDr. Jarmila Szilasiová, PhD.

Neurol. praxi. 2020;21(1):37-40 | DOI: 10.36290/neu.2020.023  

Multiple sclerosis (MS) is a heterogeneous disease in terms of its course and prognosis. The secondary progressive form of MS is determined retrospectively, based on the presence of a disability progression, independent of relapses, after an initial relapsing course. In clinical practice, the determination of SP form is often delayed due to the lack of generally accepted diagnostic criteria and biomarkers. The work deals with a review of new definitions of this form of the disease, current and prospective treatment options.

Pharmacotherapy of non-Alzheimer's types of dementia

doc. MUDr. Martin Vališ, Ph.D., prof. MUDr. Jiří Masopust, Ph.D., MUDr. Zbyšek Pavelek, Ph.D.

Neurol. praxi. 2020;21(1):41-45 | DOI: 10.36290/neu.2020.024  

The review deals with pharmacotherapy for less common dementia - frontotemporal dementia, dementia with Lewy bodies, Parkinson's disease dementia, and vascular dementia. Cholinesterase inhibitors and memantine and their pharmacodynamics and side effects are mentioned. They differ among themselves in the degree of evidence for efficacy in individual types of dementia, dosage, pharmacodynamics, and adverse effects. In addition to pharmacotherapy, it is important to include non-pharmacological approaches in the treatment of dementia, to deploy suitable drugs in time, to adequately dose and develop new molecules for the treatment of these diseases. All...

Polyneuropathy associated with levodopa/carbidopa intestinal gel infusion (LCIG)

MUDr. Milan Grofik, PhD., MUDr. Monika Turčanová Koprušáková, PhD., prof. MUDr. Egon Kurča, PhD., FESO

Neurol. praxi. 2020;21(1):46-49 | DOI: 10.36290/neu.2020.025  

LCIG is an effective treatment for the advanced stage of Parkinson's disease. Serious complication of this treatment is polyneuropathy, which can signifficantly influenced motor and non-motor functions of the patient and the quality of life. In most of the cases there is a metabolic cause of polyneuropathy due to the usage of levodopa, associated with elevation of homocysteine and deficiency of vitamins B. In case of acute polyneuropathy, it is necessary to exclude Guillain-Barré Syndrome and discontinue LCIG treatment. Each patient should be examined for polyneuropathy before the initiation of LCIG therapy and also during the treatment.

Alpha-lipoic acid and neuropatic pain

MUDr. Pavlína Nosková, Ph.D.

Neurol. praxi. 2020;21(1):50-52 | DOI: 10.36290/neu.2020.026  

Alpha-lipoic acid, a potent antioxidant, has been associated with support treatment for symptomatic diabetic neuropathy in several clinical trials. In the other indications is a subject for further research.

Cognitive rehabilitation

Mgr. Klára Novotná, Mgr. Lucie Kadrnožková, Mgr. Jana Blahová Dušánková, Ph.D.

Neurol. praxi. 2020;21(1):55-59 | DOI: 10.36290/neu.2020.005  

People with multiple sclerosis (MS) suffer many neurological symptoms including cognitive impairment. The cognitive impairment can have negative effect on employment status, social interactions and quality of life. Because currently there is no symptomatic pharmacological treatment for cognitive impairment, the cognitive rehabilitation plays a key role. This article summaries trends and possibilities in cognitive rehabilitation in MS.

Treatment of multiple sclerosis with first-line therapy and prenancy

MUDr. Mgr. Matouš Rous, MUDr. Zuzana Rous, Ph.D.

Neurol. praxi. 2020;21(1):60-62 | DOI: 10.36290/neu.2020.027  

Teriflunomide is a disease modyfing drug for treatment in multiple sclerosis as one of the options for first-line therapy. It has teratogenic and embyotoxic potential according to animal studies. The data on pregnancy use in women are limited and its use in pregnancy is contraindicated. However, there are cases where women have taken teriflunomide during conception and pregnancy.

Primary central nervous system angiitis

MUDr. Lenka Hvizdošová, MUDr. Michaela Kaiserová, Ph.D., MUDr. Andrea Bártková, Ph.D., prof. MUDr. Petr Kaňovský, CSc.

Neurol. praxi. 2020;21(1):64-67 | DOI: 10.36290/neu.2020.028  

Primary central nervous system angiitis (PACNS) is a rare disease in which aseptic inflammation of the vessels of the brain, spinal cord, and meninges occurs. Due to heterogeneous and non-specific symptoms it is one of the most difficult diseases to diagnose in neurology. In this paper we present a case of a patient with PACNS and summarize current knowledge about diagnostics and treatment possibilities of this disease.

Autoimmune encephalitis? Not. False positivity of anti-NMDA antibodies in patient with Creutzfeldt-Jacob disease

MUDr. Barbora Sklenárová, MUDr. Irena Doležalová, Ph.D.

Neurol. praxi. 2020;21(1):68-70 | DOI: 10.36290/neu.2020.013  

Anti-NMDA encephalitis is one of many types of autoimunne encephalitis (AIE), about which we are thinking during diagnostic process even more in these days. Typical symptoms of AIE are loss of memory, epileptic seizures and psychiatric symptoms. During diagnostic process is important to find positivity of antibodies, in the case of anti-NMDA encephalitis there are antibodies against N-methyl-D-aspartate receptors, which are placed on almost all neurons in the brain and spinal cord. Early diagnosis and treatment of this disease is an important prognostic factor. However there are some cases, in which there is no association between anti-NMDA antibodies...

Managing a patient with diplopia

MUDr. Svatopluk Ostrý, Ph.D.

Neurol. praxi. 2020;21(1):75-78 | DOI: 10.36290/neu.2020.032  

The author presents a brief guide and a decision tree to be used by the clinical neurologist in routine outpatient practice, e.g. during emergency hours. Emphasis is placed on symptoms that can be identified and tests that can be performed in any outpatient setting, without the need for special devices or examination tools. The aim is to more precisely determine the clinical outcome, create a rational indication for auxiliary and/or specialized examinations, to better formulate the question the referring clinician requests to be answered, and to make a responsible decision on the urgency of the condition or potential danger in delay.

Kontroverze - frontotemporální demence a onemocnění motoneuronu - jedno klinické spektrum nebo koincidence?Jedno klinické spektrum

MUDr. Lenka Krajčovičová, Ph.D., prof. MUDr. Irena Rektorová, Ph.D.

Neurol. praxi. 2020;21(1):71-72  

Kontroverze - frontotemporální demence a onemocnění motoneuronu - jedno klinické spektrum nebo koincidence?Koincidence

doc. MUDr. Stanislav Šutovský, PhD.

Neurol. praxi. 2020;21(1):73-74  

Praktické aspekty selektivní rekonstituce imunitního systému v léčbě roztroušené sklerózy

Neurol. praxi. 2020;21(1):79-81  

Jaké jsou možnosti výběru zdravotních služeb v závislosti na úhradě zdravotní pojišťovnou?

JUDr. Šárka Špeciánová

Neurol. praxi. 2020;21(1):82