Autoimunitní neuromuskulární onemocnění 

MUDr. Radim Mazanec, Ph.D. – editor hlavního tématu

Neurol. praxi. 2025;26(5):359

New treatment options for myasthenia gravis

MUDr. Stanislav Voháňka, CSc.

Neurol. praxi. 2025;26(5):366-370 | DOI: 10.36290/neu.2025.017

Myasthenia gravis is a serious autoimmune, antibody-mediated disorder of neuromuscular transmission. The condition is pathogenetically linked to thymic disease. It typically presents with skeletal muscle fatigability (including that of respiratory muscles) that fluctuates depending on fatigue and time of day. The diagnostic work-up is based on the clinical presentation, antibody testing, electrophysiology, and imaging of the thymus. Cholinesterase inhibitors are the main relief drugs. The essence of the pathogenetically-oriented treatment is thymectomy and administration of corticosteroids and immunosuppressants. Currently, novel therapeutic strategies...

Current trends in the diagnosis and treatment of CIDP

MUDr. Monika Turčanová Koprušáková, PhD., prof. MUDr. Egon Kurča, PhD.

Neurol. praxi. 2025;26(5):373-384 | DOI: 10.36290/neu.2025.016

Chronic inflammatory demyelinating polyneuropathy (CIDP) represents a heterogeneous group of immune-mediated sensory-motor demyelinating polyneuropathies, with a progressive or relapsing-remitting course. It is the duration and development of symptoms for ≥ 8 weeks that is important for the diagnosis of CIDP, although some patients may have an acute onset erroneously resembling Guillain-Barré syndrome. Conduction studies to confirm peripheral nerve demyelination remain the gold standard in diagnosis. The rarity, heterogeneous presentation, lack of highly specific diagnostic tests as well as the absence of blood biomarkers make the diagnosis of...

Acute polyradiculoneuritis - Guillain-Barré syndrome

doc. MUDr. Edvard Ehler, CSc., FEAN

Neurol. praxi. 2025;26(5):386-390 | DOI: 10.36290/neu.2024.084

GBS is an autoimmune neuropathy and is the most frequent cause of acutely deve­loped flaccid paresis. Infect or an immune impuls precede in 70 %. Molecular mimicry participates in pathogenesis. The illness developes till 4 weeks, but commonly during 2 weeks. In typical cases the GBS begins with hypesthesia and weakness of distal parts of lower etremities and then spreads in ascedent direction. Facial nerve is affected in 50 %. Paresis of ventilatory muscles may be a cause of intubation - in 30 %. Mortality undulates between 3 % and 10 %. After 6 months there are 60-80 % of patients able to walk unsupported. The relapses occure in 2-5 %. Electrophysiological...

Idiopathic inflammatory myopathies - new developments in treatment

MUDr. Heřman Mann, Ph.D.

Neurol. praxi. 2025;26(5):392-398 | DOI: 10.36290/neu.2025.013

The mainstay of treatment of all subtypes of idiopathic inflammatory myopathies, with the exception of inclusion body myositis, is pharmacotherapy with immunosuppressive and immunomodulatory agents. Different subtypes of the disease require different therapeutic approaches. Detection of myositis-specific autoantibodies, which are associated with a characteristic phenotype and response to therapy, plays an important role in deciding the choice of drug. It is always necessary to distinguish between true disease activity and damage, which cannot be influenced by pharmacotherapy. Given the increased incidence of malignancies, cancer screening is an important...

Diagnosis and scales in myasthenia gravis: development and current use in clinical practice

MUDr. Michaela Týblová, Ph.D.

Neurol. praxi. 2025;26(5):402-405 | DOI: 10.36290/neu.2025.063

Myasthenia gravis is a chronic autoimmune disorder affecting neuromuscular transmission, leading to increased muscle fatigability and weakness. In recent years, treatment options have expanded significantly, increasing the need for standardized patient monitoring. The range of available objective assessments and patient-reported outcome measures is quite wide. However, in clinical practice and research, the following four basic ones are recommended: MGFA classification, QMG score, and subjective tools such as MG-ADL and MG-QoL-15r. The key is the assessment of the treatment response by the patient himself, which is why the PASS is considered as the...

Functional/dissociative seizure vs. epileptic seizure: how to distinguish them without EEG?

MUDr. Karin Revajová, MUDr. Ondřej Strýček, Ph.D., Ing. Michal Fusek, Ph.D., doc. MUDr. Pavlína Danhofer, Ph.D., MUDr. Patrícia Všianská, doc. MUDr. Irena Doležalová, Ph.D.

Neurol. praxi. 2025;26(5):410-413 | DOI: 10.36290/neu.2025.025

Functional/dissociative seizures (previously termed "psychogenic non-epileptic seizures") are seizures that mimic epileptic seizures and are frequently mistaken for them. They are often difficult to be recognized correctly and patients may receive improper treatment, which carries the risk of complications, as documented in a short case report included in this article. Video-EEG monitoring is the gold standard in diagnosing functional seizures. However, there are clinical situations in which it is important to be familiar with the clinical manifestations of functional seizures (such as in emergency medicine). The present article introduces how functional...

Lennox-Gastaut syndrome in adulthood

doc. MUDr. Irena Doležalová, Ph.D., prof. MUDr. Milan Brázdil, Ph.D.

Neurol. praxi. 2025;26(5):415-424 | DOI: 10.36290/neu.2025.069

Lennox-Gastaut syndrome (LGS) represents a syndrome whose characteristics have recently been reviewed by the International League Against Epilepsy (ILAE). LGS is characterized not only by its development in childhood, but also by significant pharmacoresistance that greatly affects the quality of life of patients and their family members. The presence of specific seizures, including tonic seizures and at least one other type of seizure (atypical absences, atonic or myoclonic seizures, tonic-clonic seizures, focal impaired awareness seizures, non-convulsive status epilepticus, and epileptic spasms), is one of the key diagnostic features. An EEG investigation...

Paroxysmal blindness in a young patient

MUDr. Dušan Ospalík

Neurol. praxi. 2025;26(5):428 | DOI: 10.36290/neu.2025.053

Acute blindness is a severe disabling deficit. We report a case of a seventeen-year-old boy who, during a common seasonal infection, developed symptoms of complete amaurosis atypical for its paroxysmal course. The case illustrates the need for a thorough history and the irreplaceability of MRI in neurology. Hyperintense changes of the corpus callosum are a common finding on brain MRI. Cytotoxic lesions of the corpus callosum (CLOCCs) can occur due to a variety of causes ranging from metabolic or infectious ones to trauma, malignancy to autoimmunity, vaccination and others. CLOCCs may be of a transient nature and, in our case, have a good prognosis as well.

Oculomotor palsy - a diagnostic challenge

MUDr. Sabina Flašarová, MUDr. Iva Šrotová, Ph.D., MUDr. David Šálek, MUDr. Zuzana Pazdičová

Neurol. praxi. 2025;26(5):430-433 | DOI: 10.36290/neu.2025.058

Oculomotor palsy can have a variety of etiologies and can therefore present a diagnostic challenge. In the differential diagnosis, the most common are stroke, craniotraumata, inflammatory and/or autoimmune diseases. Oculomotor nerve paresis may also be the first clinical manifestation of systemic diseases, such as haemato-oncological malignancies. In this case report, we present a 48-year-old patient in whom disseminated Burkitt's lymphoma manifested specifically as an oculomotor disorder, without associated symptoms related to hematooncological disease.

A Colonial Briton from Denmark Hill: Charles David Marsden (1938-1998)

prof. MUDr. Petr Kaňovský, CSc., FEAN

Neurol. praxi. 2025;26(5):436-442

Charles David Marsden (1938-1998) was a British neurologist, one of the founders of the subspeciality of movement disorders for which the Czech language prefers to use the term "extrapyramidal diseases". He graduated from St Thomas's Hospital Medical School in London and began his career at Queen Square Neurological Hospital. However, he soon changed jobs and became a doctor at another NHS trust, Maudsley and Bethlem Royal Hospital and King's College Hospital, which were nicknamed "Denmark Hill" due to their location in London. Here, he established a centre that became the benchmark in the field of European neuroscience research for a long time; Marsden...