Neuroimunologie - úvodní slovo

Ing. MUDr. David Zeman, Ph.D. - editor hlavního tématu

Neurol. praxi. 2026;27(1):3-4

The use of flow cytometry in cerebrospinal fluid diagnostics

Ing. Inka Matuchová, Ph.D., MUDr. Ondřej Sobek, CSc., M.I.A.C., MUDr. Lenka Ceprová, doc. MUDr. Iuri Marinov, CSc., prof. MUDr. Jaroslava Dušková, CSc., F.I.A.C.

Neurol. praxi. 2026;27(1):10-14 | DOI: 10.36290/neu.2025.041

Diagnosis of central nervous system (CNS) tumor involvement is a highly responsible and demanding discipline. Qualitative cytological examination of cerebrospinal fluid (CSF) plays a key role, particularly in meningeal tumor infiltrations, allowing the detection of morphological abnormalities of cells. Subsequent special staining immunocytochemical techniques and subsequent evaluation by a cytopathologist allow these atypical cells to be specified closer. If a tumor process originating from hematopoietic cells is suspected, immunophenotyping analysis is appropriate. In a limited sample, this allows the malignant leukocyte clone to be further characterized....

The importance of cerebrospinal fluid examination in the diagnosis and differential diagnosis of neuroinfections

doc. RNDr. Pavlína Kušnierová, Ph.D., MUDr. Petr Kümpel, MUDr. Mgr. Ivana Kohnová, Mgr. Karin Lichá, MUDr. Ing. David Zeman, Ph.D.

Neurol. praxi. 2026;27(1):15-21 | DOI: 10.36290/neu.2025.054

Cerebrospinal fluid analysis represents a key diagnostic instrument in confirming and differentiating various forms of CNS infections due to its ability to reveal specific cytologic, biochemical and microbiological changes. In cases where CNS infection is suspected, a basic cerebrospinal fluid examination includes the enumeration of nucleated cells and erythrocytes, the differentiation of nucleated cells into mononuclear and polymorphonuclear cells, and, if applicable, a detailed qualitative analysis from a permanent cytological slide. Furthermore, the determination of total protein, glucose and lactate concentrations and the coefficient of energy...

Laboratory biomarkers of multiple sclerosis

MUDr. Kamila Žondra Revendová, Ph.D., MUDr. Ing. David Zeman, Ph.D., MUDr. Radovan Bunganič, MUDr. Kryštof Damián Švub, MUDr. Ondřej Pelíšek, doc. RNDr. Pavlína Kušnierová, Ph.D.

Neurol. praxi. 2026;27(1):22-26 | DOI: 10.36290/neu.2025.032

Laboratory biomarkers play a crucial role in the diagnosis, prediction, and monitoring of treatment efficacy in patients with multiple sclerosis (MS). Their use enables better individualization of therapy, increasing the chances of slowing disease progression and improving patients' quality of life. The most important diagnostic laboratory biomarkers in MS are oligoclonal IgG bands and free kappa light chains, while neurofilament light chains are essential for disease prediction and monitoring treatment efficacy. Research in this area is continuously evolving with the aim of discovering new indicators that further improve diagnostic accuracy and enable...

Clinical relevance of CSF analysis in various neurodegenerative diseases

MUDr. Zuzana André, MUDr. Barbora Gaštanová, MUDr. Andrea Kopániová, doc. MUDr. Karin Gmitterová, PhD.

Neurol. praxi. 2026;27(1):28-33 | DOI: 10.36290/neu.2025.022

Neurodegenerative diseases are broadly characterized by progressive damage of CNS with dementia being the most common clinical presentation. Several diseases fall into this category such as Alzheimer´s disease (AD), Parkinson´s disease (PD) and frontotemporal dementia (FTD). Coexisting brain pathology and clinical heterogeneity may hamper the diagnostic accuracy and delay effective treatment. Disease- specific biomarkers, alongside clinical features and imaging methods can substantially improve the diagnosis. Some of the most recent criteria rely on the involvement of CSF core biomarkers in the diagnostic work-up. Despite the distinct pathomechanism,...

Carriers of dystrophinopathies - a neglected group of patients

MUDr. Hana Drašnarová, MUDr. Livie Mensová, MUDr. Radim Mazanec, Ph.D.

Neurol. praxi. 2026;27(1):34-39 | DOI: 10.36290/neu.2025.052

Dytrophinopathies are X-linked genetic dysorders caused by Dystrophine gene mutation. The phenotypes of patients include the well-known forms of Duchenne and Becker muscular dystrophy, DMD-related dilated cardiomyopathy in men, but also less well-known and highly variable forms of dystrophinopathies in female carriers. The disease in women is most often caused by inactivation of chromosome X. It may be manifested as an isolated elevation of muscle enzymes tests, other female patients may suffer from severe muscle weakness, dilated cardiomyopathy or other extramuscular complications. The diagnostic method of choice is a molecular genetic examination...

Cluster headache - course of the attack and its clinical variants Cluster headache awareness day 2025

MUDr. Pavel Řehulka, Ph.D.

Neurol. praxi. 2026;27(1):40-44 | DOI: 10.36290/neu.2025.060

The aim of this review article is to provide information on the clinical course of cluster headache (CH). Individual attacks, cluster periods, and the long-term course of the di­sease show significant variability, which contributes to diagnostic delay. Notably, some of the CH variants are not uncommon: in a retrospective analysis of own cohort of 70 patients with CH, eight (11,4 %) did not meet the strict wording of the criteria defined by the International Classification of Headache Disorders (ICHD-3). Five patients (7,1 %) due to a change in symptom lateralization, one (1,4 %) due to atypical localization outside the first trigeminal branch (orofacial...

Speech and language impairments in people with multiple sclerosis - assessment and digital biomarkers

Mgr. Lucie Nohová, Ph.D.

Neurol. praxi. 2026;27(1):46-52 | DOI: 10.36290/neu.2026.003

From a speech therapist's perspective, multiple sclerosis causes speech (dysarthria), voice (dysphonia), and language difficulties. Currently, automated analysis is increasingly used to assess voice, speech, and language deficits, as it is much more accurate than perceptual assessment or standard tests. Acoustic analysis can be used to detect features that might be potential biomarkers for the early detection of multiple sclerosis or indicators of the severity of the disease. The aim of this paper is to present speech and language deficits in people with multiple sclerosis, outline the possibilities for their assessment using available tools with automated...

Multiple cerebral venous thrombosis under the guise of lactational psychosis

MUDr. Ing. David Černík, MBA, Ph.D.

Neurol. praxi. 2026;27(1):53-55 | DOI: 10.36290/neu.2025.062

Cerebral venous thrombosis is a rarer cause of stroke. It can be a life-threatening condition. It mainly affects women, and pregnancy and the postpartum period are also significantly at risk. Lactational psychosis is a serious psychological condition in the postpartum period, in which the woman is dangerous to herself and the newborn baby. We present a case report in which the clinical picture of encephalopathy together with the symptoms of migraine attacks in the observed migraineur faithfully imitated lactational psychosis. Early diagnosis and treatment of multiple cerebral venous thrombosis reversed the unfavorable clinical development and prevented...

Clinical presentation of purulent inflammation of central nervous system in possible autoimmune encephalitis with a good response to corticotherapy

MUDr. Šárka Reischlová, MUDr. Kateřina Matějová

Neurol. praxi. 2026;27(1):56-60 | DOI: 10.36290/neu.2025.044

Encephalitis is a serious inflammatory disease of the brain that involves a complex differential diagnostic assessment due to the wide range of possible causes. This report presents a case of a 71-year-old patient who underwent neurosurgery and subsequently developed subacute cognitive deterioration and recurrent epileptic seizures. The diagnosis of autoimmune encephalitis was prolonged due to a premorbidly diagnosed and treated structural epilepsy and the detection of serous to purulent encephalitis, which presented an atypical cerebrospinal fluid profile. Due to the lack of evidence of an infectious cause and suspicion of autoimmune encephalitis,...

Wing-beating tremor and double panda sign in a patient with Wilson's disease - case report

MUDr. Martin Daniš, MUDr. Rastislav Lackovič, MUDr. Zuzana Jankovičová, MUDr. Petra Jungová, MUDr. Natália Keléšiová, MUDr. Georgi Krastev, PhD.

Neurol. praxi. 2026;27(1):61-63 | DOI: 10.36290/neu.2025.066

In this case report, we present a 51-year-old patient who sought medical help for approximately 3 years of complaints of impaired limb mobility and coordination, altered behavior, speech articulation disorders, and gait disorders. Magnetic resonance imaging of the brain in T2-weighted images showed pathological changes in the mesencephalon namely the "face of the giant panda" sign and also the rarer "double panda sign" in pons Varoli. These MRI findings were corresponding with a metabolic disease with copper accumulation. Laboratory tests confirmed decreased serum copper and ceruloplasmin levels. Following these results, increased urinary copper excretion...

Diagnosis and treatment of myasthenic syndromes -commentary on the updated version of the German guidelines

MUDr. Michaela Týblová, Ph.D.

Neurol. praxi. 2026;27(1):74-78 | DOI: 10.36290/neu.2026.009

The German guidelines are the first to have been developed following the introduction of novel therapeutic agents. Reimbursement of these therapies in the Czech Republic differs, as does the socioeconomic context. Nevertheless, the concept of extending clinicians' attention to all active forms of generalized myasthenia gravis, not only to refractory patients, clearly deserves consideration. Therefore, we present a very concise summary of the German guidelines in Czech for the professional community.

The Great Moravian Franz Gerstenbrand (1924-2017)

prof. MUDr. Petr Kaňovský, CSc., FEAN

Neurol. praxi. 2026;27(1):64-69

Franz Gerstenbrand (1924-2017) was born in Hof in Mähren to parents who were native South Moravians from the Znaim region; his father worked as a family doctor in Hof. Shortly after little Franz was born, the family returned to South Moravia because doctor Gerstenbrand found a job as a family doctor in Unter Tannowitz. This is where Franz Gerstenbrand spent the days of his childhood and youth, graduating from a grammar school in Nikolsburg. Immediately after graduation, he had to enlist in the army, was assigned to the air force, and spent the rest of the war as an operational fighter pilot. After the war ended, he was captured by the Western Allies...

Diagnostic procedure in a patient with tremor

MUDr. Petr Hollý, Ph.D.

Neurol. praxi. 2026;27(1):70-73 | DOI: 10.36290/neu.2025.076

This article provides a clear guide for the differential diagnosis of patients presenting with tremor. It focuses on distinguishing the main types of tremor, their clinical features, diagnostic methods, and considerations. Emphasis is placed on recognizing signs that help differentiate essential tremor from Parkinson's disease or other neurological disorders. The article also includes a diagnostic flow chart to facilitate decision-making in clinical practice. It is intended for neurologists and other physicians encountering patients with movement disorders.