630
www.neurologiepropraxi.cz34080400107651332012142633073553814284484965465656086586857327828098518919109269661005
/33858040010732
Neurol.3461804001075593139165209227243
praxi.3720804001074672114152170186
2025;26(4):293-2963923804001074487128172185230272295337358373417460502529568611656
/46248040010731
NEUROLOGIE47018040010758101158205268310370429450493
PRO5216804001074591154
PRAXI5391804001074591148201221
29356558020012657115171
HLAVNÍ4945200012670127198263336370
TÉMA5337200012657114204274
Benigní406636001063466107125164205223
paroxyzmální430436001063370105146181219253308349380421439
polohové475836001063374106145186227264296
vertigo507036001063668104135153192233
u5318360010639
seniorů537336001063162103121161197238
Benigní3409200298145271411475615754819
paroxyzmální1207920029814426935949661674886210701196126013991464
polohové271992002981442823474856257628841005
vertigo37739200298127248339430496635773
u45949200298140
seniorů47829200298104230370434572662799
doc.3401320013766129179209
PhDr.5721320013763127204246269
Ondřej8641320013778144210252310342
Čakrt,12281320013765123183226269299
Ph.D.,15491320013764128157235261291
Mgr.18621320013793158201224
Klára2108132001376799157199257
Kučerová,23871320013767129179237280343400458487
Ph.D.28971320013764127156235261
Klinika340148001336087111172197247301
rehabilitace664148001333691152204266292317341377431480533
a12201480013353
tělovýchovného1297148001333690115176227282330390450502563618679739
lékařství2060148001332681132186221265302357383
2.2466148001335679
LF25691480013352104
UK26971480013371130
a28501480013353
FN29271480013353123
Motol,30731480013389150185244270292
Praha3389148001335893145206258
Benigní3401990012155105160183238293316
paroxyzmální6821990012158106138192237287332415463486540563
polohové12711990012158113137192247302349397
vertigo1695199001214897129165187243298
(BPPV)2019199001212982135186242272
je2318199001212575
nejčastější24191990012156106130174222261294343366404427
vestibulární2873199001214897136169192248303326373405461483
poruchou,33831990012157113145200245299354409429
přičemž340213001215789111155203285327
její68621300121247497119
výskyt824213001214897136182231266
výrazně1109213001214898131178220275324
stoupá1452213001214073126180236284
s17542130012140
věkem.1813213001214997143191273293
U21252130012165
seniorů2209213001214089144166220252306
se2534213001214089
BPPV26422130012154107158212
často2873213001214593131164217
projevuje3109213001215688142165214261315338387
odlišně35152130012155111134156194248297
než3402270012155104145
u5002270012155
mladších5732270012183105151206244265308361
pacientů9502270012156103146167216270301353
–13192270012149
místo13842270012182104141173226
typické1625227001213381137159202247294
polohové19342270012156110133186240294339386
závrati2336227001214290135167213244266
dominuje26172270012156109191213266319341389
spíše3022227001213994116155204
pocit32412270012156111154176207
nejistoty34642270012155103126147185217269300349
a3402410012147
posturální4052410012156110147179231262308330382404
instability,823241001212376113145192246268289310341389403
což1241241001214495135
často1391241001214491128159211
vede1617241001214794149197
k18292410012146
chybné1893241001214496140195248296
diagnostice2204241001215577122176229282319351372414461
a26802410012147
opožděné27452410012154109162202256304357406
léčbě.3165241001212472115169218235
Základem34152410012154101146169214269317397
léčby340255001212372117172217
jsou572255001212462116170
repoziční757255001213381137191232254297351373
manévry,11452550012183130184233279311360375
které1536255001214681129160209
mají17602550012183130152174
při1950255001215688110
správném2076255001213994126173218273322404
provedení2495255001215788142187235291340394416
úspěšnost2927255001215492147197235288342380413
až3355255001214890
8034612550012151101
%,3578255001217999
ale3693255001214870119
u3402690012155
seniorů414269001214089144166220252306
je736269001212473
často825269001214592131163216
nutné10572690012156109141196245
je1318269001212473
modifikovat14072690012184138194216244270315368414461493
kvůli1916269001214696151173195
přidruženým2127269001215789111167198252294343398442525
omezením26682690012155137187229278333355437
a31212690012148
počítat31882690012157111156178210257289
s34932690012139
výskytem3551269001214898136182231340283001213381164
reziduální525283001213382124147202256303325379402
instability.948283001212378116148196252275297319351400415
V13852830012155
praxi1460283001215688136182205
je1686283001212574
hlavním1782283001215577124170225247329
problémem2133283001215789142198221271353403485
nedostatečná26402830012155105161215253286334366414459513560
implementace32212830012123106161184234316366420452500543591
diagnostických340297001215577122176229281319350372414458506548601
a9552970012148
léčebných1021297001212371114161215269312354406
postupů,14422970012156109146178231285338357
kdy1814297001214699144
pouze19732970012156109162203251
třetina2238297001213363111142163216262
pacientů25142970012156103145166214268298350
podstoupí28792970012156109164201233285338392414
diagnostické3307297001215677123176229282319351372414459505
manévry3403110012183130185234281313363
a7213110012148
dostane7883110012157111149182230284333
adekvátní11403110012148104153199249297328383405
léčbu.1563311001212473117173227247
Pro1828311001215484138
úspěšnou1984311001215594149199237291346400
léčbu2402311001212473118173227
je2648311001212473
klíčová274031100121477193136189235282
včasná3041311001214890138176230277
diagnostika3336311001215779126181235289327360382428476
a3403250012148
provedení407325001215789143189237293343397419
repozičních851325001213381138192233256299354376419473
manévrů.13493250012183130185234281313367387
U17603250012165
pacientů18443250012157105148170220274306359
s22283250012139
reziduální2287325001213281123146201255302325379401
instabilitou2712325001212478116149197252275297319351404459
indikujeme3195325001212478133156201256278328410460
následnou36793250012156103340339001214062111168222276330
rehabilitaci,689339001213382137184239262284306338386430452471
která1180339001214781130162209
by14083390012157103
měla15303390012183133156202
probíhat1752339001215789142198221277324356
po21273390012157112
dobu22583390012156110166221
4–624983390012151103158
týdnů.2675339001213382136191244264
Klíčová340355001246190118163221273326
slova:689355001244372130182235261
vestibulární974356001214897137171194250306329377409465488
systém,1486356001214088128161211294315
závrať,1825356001214393139173221254275
porucha21243560012157113146201246301349
chůze,24973560012145100155197247267
instabilita,2788356001212479118152201257281304327360409430
repoziční3242356001213383140196237261305361384
manévry,365035600121831313403700012155106154187237253
reziduální614370001213383126150206261309333388411
závrať.1046370001214393139172221254275
Benign3403970012460114174201260320
paroxysmal6803970012460113152210261317360447500528
positional12283970012460119162190228256315374427455
vertigo17033970012453105144183212271329
in2052397001242887
the2159397001243797150
elderly2329397001245382142195235262315
Benign3404150012155104158180234288
paroxysmal6534150012157105136189233281320401448470
positional11484150012157112149170202223277331378400
vertigo1573415001214896127161183237291
(BPPV)1889415001212880133183237267
is2181415001212361
the2267415001213387136
most24274150012185138176208
common2660415001214598180262316371
vestibular3055415001214996134167188243297319366397
disorder3476415001215779116170201256305337
and3404290012149102158
its52242900121245594
incidence641429001212377121142197246300344391
increases1057429001212377120151200246284333370
significantly1452429001214061116170191219243286334387418440486
with1962429001217496128181
age.21684290012149103152170
In2363429001212478
the2466429001213387136
elderly,2626429001215173128177208230276290
BPPV29414290012155107157211
often3177429001215583117165219
manifests34214290012184131184206234282320353392
differently340443001215677104134182213260313343364409
than763443001213285131183
in960443001212376
younger1049443001214799152205258306337
patients13994430012157103133154202255285323
-17364430012130
rather1780443001213278108161209239
than2033443001213385131184
the2230443001213386134
typical2377443001213381136157200246267
positional26584430012156110146167198218271324370391
vertigo,3062443001214895125159180233286303
a33784430012148
feeling3444443001212976125147167220274
of3731443001215581
uncertainty3404570012155107150196226260306327379409456
and8104570012147100154
postural9774570012157110147178230260306327
instability1317457001212476112144190244265286307337384
dominates,17154570012156108189210262307337384421440
often2168457001215481115162215
leading2396457001212371116170191244297
to2706457001213384
misdiagnosis28044570012183103140194215260313366418455475512
and33294570012148101155
delayed34974570012156103125170213260315
treatment.340471001213363111157187268317370401420
The7744710012149103152
basis9404710012156103140161198
of1152471001215482
treatment1247471001213364111157188269317371401
is1662471001212360
repositioning1736471001213380135189226247278299352405426479533
manoeuvres,22834710012183129182235284337383415462500519
which28154710012174128149191244
have30734710012155101146193
a32794710012148
success3345471001213991134176223260297
rate3656471001213379109156
of340485001215582
up4384850012155109
to563485001213385
806644850012151101
%7744850012179
when8684850012174128176230
performed11134850012157106137167221251333382437
correctly,1566485001214496127158206250283304350364
but19454850012157110142
in2102485001212477
the2194485001213387135
elderly2345485001215072126175205227273
it2633485001212455
is2703485001212461
often2779485001215583117164218
necessary30124850012156104148195233270317347395
to3423485001213385
modify35244850012183136192213240289
them340499001213386135216
due5804990012156109157
to761499001213385
associated869499001214986123176220241286317364419
limitations1312499001212445126147178225255276329383420
and17564990012148101156
to1935499001213385
take2044499001213380124171
into2239499001212376107159
account2421499001214991133185238291322
the2766499001213386135
occurrence2924499001215599140193224255303356399446
of3394499001215582
residual3499499001213381118139194246293314
instability.340513001212377114145192247269290311342390404
In762513001212477
practice,857513001215787134177210231274321339
the1213513001213386135
main13655130012184130151204
problem1587513001215788140195217266347
is1952513001212360
the2030513001213386135
lack2182513001212470113157
of2357513001215582
implementation24565130012124105159181230311360414444491521542595649
of3123513001215482
diagnostic3222513001215778124177231284321353374417
and36565130012149102156
treatment340527001213363110155185266314367396
procedures,750527001215687138181228282334364412449467
with1230527001217395125178
only14215270012154108129173
one16085270012154107155
third1776527001213385106136189
of1979527001215481
patients20735270012157103133153201254284322
undergoing24085270012155107161209239292345366418472
diagnostic2893527001215677122175228280317348369411
manoeuvres33175270012183128181233282334380411458495
and3405410012148101156
receiving513541001213280124171192239261314368
adequate8975410012149103152207260306336383
treatment.1297541001213364112158188269318372402421
Early1735541001214996126148193
diagnosis1945541001215678124177231284321342379
and23415410012148101156
implementation25135410012124105160182230311360414444491521542595649
of3179541001215582
repositioning3277541001213381136190227248279300353407428481535
manoeuvres3405550012183129183236285338384416464501
are862555001214878126
crucial1009555001214575129172193238260
for1290555001212982113
successful1423555001214092135177224262299327381402
treatment.1846555001213363111157188269318371402421
In2288555001212377
patients23865550012156103134155203257287326
with2732555001217496127180
residual2932555001213381118139194247293314
instability,3267555001212376113145192247268290311342390404
we36915550012174121
indicate340569001212377131152195242272320
follow-up677569001212982104125178249279333388
rehabilitation,1082569001213381134180235257278299330377407428482535554
which16535690012174128149192245
should1915569001213993146199220275
take2207569001213380125172
place2396569001215779125168215
over26285690012155100147178
4–628235690012151103156
weeks.29965690012173121170215256275
Key3405850012460111161
words:5175850012475131168227270295
vestibular829586001214795134167189244298321367399
system,1245586001213986124157205287307
vertigo,1569586001214795127162184239292311
gait18975860012155102124156
disorders,2070586001215578116170202256305337377397
postural24845860012156110148181235266314336
instability,2837586001212377115148195251274296318350399414
repositioning3268586001213281136191229251283305359414436490545
manoeuvres,3406000012183131187242293348396430480519540
residual901600001213383122145202257305328
vertigo.1250600001214897130166189245300320
Epidemiologie3406470014762133164235297400431499531599669701763
Závratě480664001095196139171216246292
se798664001093683
vyskytují907664001094491128172218252303325347
u12816640010950
15–351351664001094789137183228
%16056640010973
dospělé17046640010952103139192239262308
populace,3406780010951102154204225269310354372
přičemž732678001095181102143187263302
tento1053678001093075125155204
podíl12766780010951102154175198
může14936780010975125164209
stoupat1722678001093566115165217261290
až340692001094380
k4356920010941
50493692001094690
%5976920010970
u6816920010948
osob747692001094883131181
ve942692001094386
věku1042692001094285126175
nad1231692001094991141
801386692001094591
let149169200109216594
(Fancello1599692001092567106155194237258278326
et1939692001094574
al.,34070600109436584104
2023).463706001094691136182205222
V7047060010950
klinické77370600109436586136158198241285
praxi1077706001095181125168190
je1286706001092268
benigní1373706001095197148169219270291
paroxyzmální16837060010951951251742162613023407200010975119140190211
polohové5777200010951102124174224274317362
vertigo964720001094388118150171222272
(BPPV)1261720001092674123170221249
zodpovědné1535720001093988140192242285330382432477
za340734001093984
přibližně443734001095181102153175197235286331
třetinu793734001093059104135156206256
případů,1067734001095282103154199250300319
kde1404734001094393139
jsou1561734001092258108158
závratě1738734001093883126156200230274
způsobeny340748001093992143180231284332383426
poruchou7927480010952104135186228279330382
vestibulárního1200748001094490127158180233284306351381433455508559
systému,17867480010936811181491953407620010975125144
a5027620010944
je565762001092267
tak650762001093075117
jeho785762001092268118168
nejčastějším972762001094995117158202237268313335370391467
onemocněním14577620010949100146221271313363409459480555
v3407760010943
dospělosti4017760010951100135185231252301337367387
(Furman804776001092568115144219262311
et1131776001094474
Cass,1221776001095195130165184
1999).1420776001094686133179203219
Navzdory16557760010958102143183234283313357
tomu,2140650001093079154204223
že2380650001093884
BPPV2480650001094997144195
je2691650001092268
nejběžnější2775650001095096118169215254305350372408429
vestibulární3220650001094388124155176227277299342372423444
poruchou,368065000109511022140664001093082124176227279299
je2465664001092370
jeho2561664001092370122174
rozpoznání2761664001093081121174226265317362414436
v32246640010944
primární3288664001095283106183228259311333
péči36486640010952100143164
často2140678001094084120151200
opomíjeno,23596780010949101152227249271317367417435
zejména2813678001093984106181227278321
u31536780010950
seniorů.3222678001093681132153203233283302
Epidemiologická2280692001094596118170216292314364386437489510551594639
data2945692001095195125170
ukazují,3140692001095093138178229251272291
že3457692001093985
prevalence35676920010952821281722162140706001092168119161206
BPPV2372706001094998146197
se2595706001093682
v27037060010944
celkové2767706001094186108151201244289
populaci30827060010952103156207229273314336
pohybuje34447060010951103154196249300322368
v21407200010943
rozmezí2201720001092877114188232271291
10,7–1402507720001094687105149190230270317
případů2839720001095079100150194244292
na3146720001094992
1003253720001094587133
0003401720001094693140
obyvatel3556720001094899140186228214073400109297394
(Bhattacharyya2249734001092572121164192224267306355397426470515558
et2822734001094474
al.,291173400109426381100
2017).3026734001094589131170194211
Podle3252734001094794144165209
německé3476734001094994167212252293337
studie2140748001093667116168189234
využívající2397748001094389140179200244288310331372393
telefonický281274800109307597143170220270291332374420
dotazník32557480010950100130175214264285330
je3607748001092268
celoživotní36977480010941852140762001092170108129173221250300321
prevalence2476762001095181125168211232277327367411
BPPV2903762001094896143193
v31117620010943
dospělé3173762001095099135185231252297
populaci34867620010951101152202223266306326
2,42140776001094563109
%,2264776001097089
s23697760010935
roční2421776001092978118166187
incidencí2623776001092169109129179224273313333
0,62971776001094663109
%.3095776001097090
Idiopatické320077600109217192141191234263283323364407
BPPV3622776001094895141191
DECLARATIONS:4070201008648871301662142563043393604124625014571201008514
Declaration406921500874987120141179207245272292334376
of445921500874166
originality:45392150087406888131151193231252272299338358
The406922600853473109
manuscript418922600855791130168195227249266306329
is452922600851644
original45842260085386178117133172205222
and481722600853472112
has49402260085387299
not50512260085387699
been516222600853975110149
published532222600854078118135151178217252292
or406923700853862
submitted414623700852867108167184208234269310
elsewhere.44712370085355381117169209246269305320
Ethical406925100873764107127160198219
principles43022510087427090132165185229249288319
compliance:463625100873172134177198218256298331369388
The406926200853678116
authors420626200853475100142183208238
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