Zaznělo na XIX. Neuromuskulárním kongresu, 23.–24. dubna 2026, BrnoZaznělo na

MUDr. Eva Gavendová

Neurol. praxi. 2026;27(3):240-245

Zaznělo na 38. českém a slovenském epileptologickém sjezdu, 9.-10. dubna 2026, České BudějovicePacienti s Lennox-Gastaut syndromem v éře moderních terapiíZaznělo na

MUDr. Zuzana Zafarová

Neurol. praxi. 2026;27(3):235-239

Zaznělo na 13. konferenci Neurologie pro praxi, 27.-28. ledna 2026, Plzeň – Co bychom měli vědět o magneziuZaznělo na

MUDr. Zuzana Zafarová

Neurol. praxi. 2026;27(3):231-234

Subacute progressive polyneuropathy as a manifestation of Churg-Strauss syndrome - a case reportCase report

MUDr. Kristián Šveda, doc. MUDr. Milan Grofik, PhD., MUDr. Monika Turčánová Koprušáková, PhD., MUDr. Jana Olekšáková, PhD., prof. MUDr. Egon Kurča, PhD., FESO

Neurol. praxi. 2026;27(3):227-230 | DOI: 10.36290/neu.2025.031

Eosinophilic Granulomatosis with Polyangiitis (EGPA), also known as Churg-Strauss Syndrome, is a disease characterized by necrotizing vasculitis affecting medium- and small-caliber arteries. Approximately 40-50 % of patients with EGPA have positive ANCA antibodies and exhibit a "vasculitic" phenotype, presenting with myalgias, migratory polyarthralgias, weight loss, mononeuropathy multiplex, and renal involvement. This article describes the case of a 55-year-old patient with subacute-onset symmetrical axonal polyneuropathy and negative ANCA antibodies, who was diagnosed with EGPA. The presented case highlights the importance of through differential...

Chronic pain and its treatment optionsTrends in neuropharmacotherapy

MUDr. Šimon Kozák

Neurol. praxi. 2026;27(3):222-226 | DOI: 10.36290/neu.2026.035

Chronic pain is a major healthcare problem with significant impact on quality of life and healthcare resources. It is defined as pain persisting for more than three months and may arise from multiple pathophysiological mechanisms. Musculoskeletal disorders such as osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis represent common causes. Management of chronic pain requires a comprehensive approach combining pharmacological and non-pharmacological strategies. Nonsteroidal anti-inflammatory drugs (NSAIDs) remain an important option for symptomatic treatment of inflammatory pain. Aceclofenac, available for example as Biofenac 100 mg film-coated...

Neurofilament light chain (NfL) and glial fibrillary acid protein (GFAP) as biomarkers disease activity and therapeutic response in multiple sclerosis treated with ocrelizumabTrends in neuropharmacotherapy

prof. MUDr. Pavel Štourač, Ph.D.

Neurol. praxi. 2026;27(3):218-221 | DOI: 10.36290/neu.2026.033

Multiple sclerosis is chronic autoimmune disease with very variable interindividual clinical course and response to the treatment. There is an effort to find biomarkers which reflect two basic aspects of immunopathogenesis of multiple sclerosis, i.e. inflammatory activity and neurodegeneration. We have two biomarkers, neurofilament light chains and glial fibrillary acidic protein measured in serum which mirror both processes, i.e. neuroinflammation and neurodegeneration. We will be able to evaluate the drug efficacy, as shown in this report specifically of ocrelizumab in multiple sclerosis and to modify the treatment according to the principles of...

Genetics in neurology: What can be expected from genetic testing in neurological patients?From the boundary of neurology

RNDr. Anna Uhrová Mészárosová, Ph.D., Mgr. Alena Musilová, Ph.D., doc. MUDr. Dana Šafka Brožková, Ph.D.

Neurol. praxi. 2026;27(3):208-217 | DOI: 10.36290/neu.2026.016

A large proportion of neurological diseases have a genetic origin, and this genetic background cannot be simplified into a single category. Conversely, most genetically determined diseases have neurological manifestations. Furthermore, thanks to current molecular genetic methods and new treatment options for genetic diseases, we are on the threshold of a new era. Currently, exome sequencing is the gold standard for investigating heterogeneous diseases, which include most genetic neurological disorders. However, like other diagnostic molecular genetic methods, it has its limits and specific applications. Despite the rapid development of genetic diagnostic...

Pain as one of the symptoms of multiple sclerosisReview articles

MUDr. Zuzana Rous, Ph.D.

Neurol. praxi. 2026;27(3):203-207 | DOI: 10.36290/neu.2026.005

Pain is a common, but often underestimated symptom of multiple sclerosis (MS). It significantly affects the patient's quality of life, working capacity as well as their mental state. The most common type is neuropathic pain, followed by pain associated with spasticity and nociceptive musculoskeletal pain; moreover, patients with MS tend to develop headaches more frequently. Diagnosing the type of pain and choosing the appropriate treatment are often challenging and require a multidisciplinary approach. The article presents an overview of the pathophysiology, clinical forms, diagnostic options, and current therapeutic approaches to pain management in...

Gold Coast Criteria - new criteria for determination the diagnosis of amyotrophic lateral sclerosisReview articles

doc. MUDr. Edvard Ehler, CSc., prof. MUDr. Ivana Štětkářová, CSc., MHA

Neurol. praxi. 2026;27(3):200-202 | DOI: 10.36290/neu.2025.067

Amyotrophic lateral sclerosis (ALS) is a systemic and fatal neurodegenerative disorder with degeneration of central and peripheral motoneurons, non-motor symptoms and non-interrupted progression of disease. The old diagnostic criteria are very complicated and setting of diagnosis comes late, frequently at the terminal stage of disease. The new diagnostic criteria - Gold Coast criteria - were developed by a group of specialists in 2020 and their implementation in clinical practise will shorten the time to the diagnose setting. This will be advantageous for new treatment introduction, for shortening of repeated and often demanding methods and for providing...

Integrated approach to the treatment of spastic paresis using botulinum toxin and physiotherapyMain topic

Mgr. Ota Gál, Ph.D., prof. MUDr. Robert Jech, Ph.D., Mgr. Václav Matys, MUDr. Martina Hoskovcová, Ph.D.

Neurol. praxi. 2026;27(3):194-199 | DOI: 10.36290/neu.2026.032

Spastic paresis represents a complex clinical syndrome and it's management requires an integrated approach combining pharmacological interventions with targeted physiotherapy. This article summarizes key aspects of the pathophysiology, assessment, and treatment of spastic paresis, with particular emphasis on the role of botulinum toxin and contemporary physiotherapeutic approaches. The aim is to provide practical guidance for optimizing treatment plans in patients with spastic paresis.

Botulinum toxin in the treatment of headacheMain topic

MUDr. Simona Szabóová, MUDr. Oľga Duraníková, PhD., prof. MUDr. Peter Valkovič, PhD.

Neurol. praxi. 2026;27(3):188-193 | DOI: 10.36290/neu.2026.020

Onabotulinumtoxin A (OnaBoNT/A) is a neurotoxin with a complex mechanism of action that influences not only neuromuscular transmission but also the modulation of neurotransmitters and neuropeptides, which play a key role in the pathophysiology of primary and certain secondary headache disorders. Currently, OnaBoNT/A is considered an effective and safe prophylactic therapy for chronic migraine and has been approved for this indication by both American and European regulatory authorities. It also represents a promising treatment option for other types of headaches, including trigeminal autonomic cephalalgias and trigeminal neuralgia. Further expansion...

Botulinum toxin treatment of oromandibular and laryngeal dystoniaMain topic

MUDr. Monika Turčanová Koprušáková, PhD., MUDr. Jozef Haring, PhD., MUDr. Ján Necpál, PhD.

Neurol. praxi. 2026;27(3):181-185 | DOI: 10.36290/neu.2026.022

Oromandibular and laryngeal dystonia are relatively rare focal dystonia with diverse etiology and clinical presentation. Although botulinum toxin treatment is considered off-label in both, empirical experience points to its effect and justification in clinical practice. Adequate erudition in application, often with the need for EMG navigation, and multidisciplinary patient care in both types of diseases increase the likelihood of symptomatic improvement of their condition.

Botulinum toxin in the treatment of cervical dystonia, blepharospasm and eyelid opening apraxiaMain topic

MUDr. Vladimír Haň, PhD., MHA

Neurol. praxi. 2026;27(3):176-180 | DOI: 10.36290/neu.2026.019

Focal dystonias are a heterogeneous group of movement disorders for which botu­linum toxin type A is the first-line treatment. Despite its proven efficacy, up to one-third of patients report suboptimal outcomes, often due to incorrect muscle targeting, inadequate dosing, or technical limitations. Guidance techniques such as EMG and ultrasound significantly enhance therapeutic efficacy. Botulinum toxin type A is essential in managing cervical dystonia, blepharospasm and apraxia of eyelid opening. Optimal care requires an individualized approach, including dose and interval adjustments, as well as targeted management of non-motor symptoms that influence...

The history of treatment with botulinum toxin in the Czech Republic and Slovak RepublicEditorial

prof. MUDr. Petr Kaňovský, CSc., FEAN, prof. MUDr. Jan Benetin, Ph.D., prof. MUDr. Egon Kurča, Ph.D., FESO

Neurol. praxi. 2026;27(3):167-171 | DOI: 10.36290/neu.2026.029

The first reports of the therapeutic use of botulinum toxin in the former Czechoslovakia date back to the early 1990s when several patients were treated for blepharospasm in Prague. After the country's split, so-called extrapyramidal centres (or centres for abnormal movements, or centres for neurodegenerative diseases, with the names not having been standardized) were established in both parts of the country, and botulinum toxin therapy naturally became concentrated there. Czech and Slovak neurologists conducted both experimental and corporate research, which resulted in a number of interesting discoveries that subsequently led to improvements in treatment...

Risdiplam u dospělých pacientů se spinální muskulární atrofií: zkušenosti z klinické praxe - Publikujeme v zahraničíLiterature reviews

MUDr. Olesja Parmová, Ph.D.

Neurol. praxi. 2026;27(2):152

Spastic paraplegia with neuropsychiatric abnormalities and the thin corpus callosum don´t forget about the hereditary spastic paraplegia type 11Video case reports

MUDr. Ján Necpál, PhD., MUDr. Bibiána Jeleňová, MUDr. Ján Kothaj

Neurol. praxi. 2026;27(2):156-161 | DOI: 10.36290/neu.2026.013

Hereditary spastic paraplegia type 11 (SPG11) is the most frequent autosomal recessive HSP. In addition to progressive spastic paraplegia, it also presents with various neuropsychiatric abnormalities and typical picture of thin corpus callosum on MRI. Parkinsonism or dystonia or typical ophthalmologic features with retinal degeneration, can sometimes also present. Typical combination of the HSP11 symptoms should lead to targeted genetic testing of the SPG11 variants. Complex management includes physiotherapy, treatment of spasticity, movement disorders and neuropsychiatric symptoms. In this case series, we present three short case reports coming...

From paresthesias to the diagnosis of spinal cord ischemiaCase report

MUDr. Natália Cvengrošová, MUDr. Pavel Potužník, Ph.D., MUDr. Ing. Radek Tupý, Ph.D.

Neurol. praxi. 2026;27(2):145-150 | DOI: 10.36290/neu.2025.068

Paresthesia, as a typical positive sensory symptom, is a common subjectively reported symptom in patients of all age groups. As they can be a manifestation of both central and peripheral nervous system disorders, differential diagnosis is not always straightforward. We describe the case of a young patient, with sudden onset of right-sided hemiparesthesia and objectively mild paresis of the right lower limb, in whom the nature of the difficulties, her young age, the results of imaging and laboratory examinations as well as the information about recent delivery initially led us to consider a possibility of multiple sclerosis. However, further investigation...

A battle for grey matter: is Ocrelizumab gaining an advantage?Trends in neuropharmacotherapy

MUDr. Simona Halúsková, Ph.D., MBA, MUDr. Miroslav Mareš, MUDr. Alena Martinková, MUDr. Linda Bláhová, MUDr. Věra Křivková, MUDr. Marek Klíma

Neurol. praxi. 2026;27(2):139-144 | DOI: 10.36290/neu.2026.018

Brain atrophy represents one of the most sensitive markers of neurodegeneration in multiple sclerosis (MS), and its extent closely correlates with long-term disability and cognitive performance. Grey matter atrophy and atrophy of deep brain structures are of particular importance, as they reflect ongoing neurodegeneration more accurately than traditional inflammatory measures. Ocrelizumab, a highly effective anti-CD20 therapy, has been shown to reduce disease activity and slow both global and regional brain tissue loss, including structures that are most vulnerable to neurodegeneration., with a possible impact on preserving the functional reserve of...

Novel therapeutic options in hereditary neurodegenerative cerebellar ataxiasTrends in neuropharmacotherapy

doc. MUDr. Martina Bočková, Ph.D., MUDr. Tomáš Boušek, MUDr. Jaroslava Paulasová-Schwabová, Ph.D., doc. MUDr. Martin Vyhnálek, Ph.D.

Neurol. praxi. 2026;27(2):133-138 | DOI: 10.36290/neu.2026.010

This review summarizes current options for both disease-modifying and symptomatic treatment of degenerative cerebellar ataxias, with a particular focus on two conditions that are significantly reshaping everyday neurological practice: Friedreich's ataxia (FA), with the recent availability of the targeted therapy omaveloxolone, and spinocerebellar ataxia type 27B (SCA27B), for which accumulating evidence supports the efficacy of 4-aminopyridine (4-AP).

The use of digital media as a source of information for patients with multiple sclerosisReview articles

MUDr. Iva Šrotová, Ph.D., MUDr. Sabina Vejrychová, MUDr. Marta Vachová, MUDr. Viktorie Svobodová

Neurol. praxi. 2026;27(2):130-132 | DOI: 10.36290/neu.2025.077

In today's digital age, patients with multiple sclerosis (MS) are increasingly going online in search of information to help them manage this chronic disease. This article focuses on the different ways patients use digital media, including social networking sites, professional websites, mobile apps, and virtual communities, and their impact on quality of life, disease knowledge, and treatment decisions.

Targeted silencing: antisense oligonucleotides and genetic forms ALSMain topic

MUDr. Daniel Baumgartner, Ph.D., MUDr. Adam Betík, doc. MUDr. Eva Vlčková, Ph.D.

Neurol. praxi. 2026;27(2):125-129 | DOI: 10.36290/neu.2025.084

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder with limited therapeutic options. Tofersen, an antisense oligonucleotide targeting SOD1 mutations, represents the first approved gene therapy for ALS. Clinical studies demonstrated a significant biological effect through reduction of SOD1 protein and neurofilament levels, although short-term clinical benefit was not consistently confirmed. Long-term and real-world data suggest slowed disease progression, particularly when treatment is initiated early. Despite the occurrence of adverse events, the overall benefitrisk balance is considered favorable, as reflected by conditional...

Current genetic therapy options for transthyretin amyloidosisMain topic

prof. MUDr. Eva Vlčková, Ph.D.

Neurol. praxi. 2026;27(2):119-124 | DOI: 10.36290/neu.2025.082

Transthyretin amyloidosis (ATTR) is a severe, progressive multisystem disorder caused by the deposition of amyloid fibrils derived from pathologically unstable transthyretin in various tissues. Clinically, it most commonly manifests as rapidly progressive axonal sensory‑motor polyneuropathy with early autonomic nervous system involvement and/or cardiomyopathy. The development of disease‑modifying therapies, particularly gene "silencers" (molecules that suppress the expression of a specific gene at the mRNA level) based on small interfering RNAs (patisiran, vutrisiran) and antisense oligonucleotides (inotersen, eplontersen), has fundamentally...

From genetic diagnostics to gene therapy in epileptologyMain topic

MUDr. Ondřej Horák, doc. RNDr. Lenka Fajkusová, CSc., doc. MUDr. Hana Ošlejšková, Ph.D.

Neurol. praxi. 2026;27(2):114-118 | DOI: 10.36290/neu.2026.021

The field of genetic epilepsies, and especially developmental and/or epileptic encephalopathies, has undergone literally revolutionary changes over the past 15 years. With the rapidly growing number of identified "epilepsy-associated" genes and the increasing understanding of the enormous genotypephenotype variability, modern molecular-genetic methods based on the principle of massive parallel sequencing have been developed and implemented in clinical practice. These methods make it possible to diagnose, etiologically classify, and clinically characterize a wide range of new monogenic entities, to better understand their pathogenetic basis, and, last...

Metachromatic leukodystrophy diagnostic and therapeutic optionsMain topic

doc. MUDr. Miriam Kolníková, PhD., MUDr. Klára Brožová, Ph.D.

Neurol. praxi. 2026;27(2):109-113 | DOI: 10.36290/neu.2026.007

Metachromatic leukodystrophy (MLD), caused by arylsulfatase A deficiency, is characterized by three clinical subtypes: late infantile, juvenile (early and late) and adult form. Regression of motor and mental functions with finding of leukodystrophy on brain MRI is the reason for further laboratory examination. The diagnosis of MLD is established by confirmation of arylsulfatase enzyme deficiency, finding of sulfatides in urine and subsequent genetic examination of pathogenic variants of the ARSA gene. Targeted therapy is allogenic hematopoietic stem cell transplantation (HSCT), which is used in patients with pre- and very early symptomatic forms of...

Hope through gene therapy: a modern approach to treating AADC deficiencyMain topic

MUDr. Martin Macháček, doc. MUDr. Hana Ošlejšková, Ph.D., doc. MUDr. Pavlína Danhofer, Ph.D.

Neurol. praxi. 2026;27(2):101-106 | DOI: 10.36290/neu.2026.012

Aromatic L-amino acid decarboxylase deficiency (AADC-D) is a rare and underdiagnosed neurotransmitter disorder caused by autosomal recessive mutations in the DDC gene. The resulting enzyme deficiency leads to reduced synthesis of monoamine neuromodulators, causing severe impairment of motor, behavioral, and autonomic functions. Until recently, therapy was purely symptomatic, relying on dopamine agonists, monoamine oxidase inhibitors, and pyridoxine. The introduction of eladocagene exuparvovec gene therapy represents a major breakthrough. This stereotactically guided intraputaminal administration of an AAV vector carrying the functional DDC...

Gene-based therapy for neuromuscular diseasesMain topic

MUDr. Aneta Podsedníková, MUDr. Lenka Juříková, Ph.D.

Neurol. praxi. 2026;27(2):96-99 | DOI: 10.36290/neu.2026.004

Hereditary neuromuscular disorders (NMD) are a broad group of diseases affecting peripheral nerves, muscles, or neuromuscular transmission. They are considered rare diseases with variable clinical presentation. A common feature of NMD is muscle weakness, which is progressive and can lead to respiratory failure in some patients. In the past, therapy for genetically conditioned NMD consisted only of symptomatic care without the possibility of influencing the natural course of the disease. A breakthrough occurred with the advent of gene therapy for spinal muscular atrophy (SMA). Progress has also been made in the treatment of muscular dystrophies. The...

Challenges and perspectives in the diagnosis of undiagnosed pediatric patients and an overview of therapeutic options in rare diseasesMain topic

MUDr. Kateřina Slabá, Ph.D., Mgr. Petra Pokorná, Mgr. Kamila Říhová, Ph.D., doc. MUDr. Regina Demlová, Ph.D., prof. RNDr. Ondřej Slabý, Ph.D.

Neurol. praxi. 2026;27(2):89-95 | DOI: 10.36290/neu.2026.017

Rare diseases represent a broad and heterogeneous group of disorders that are predominantly genetically determined. Currently, more than six thousand clinical entities have been identified, which collectively affect approximately 68% of the global population and pose a significant healthcare and socioeconomic burden. Major advances in molecular genetics, particularly the introduction of whole-exome and whole-genome sequencing, have markedly shortened the time to diagnosis and enabled the discovery of new genetic causes of disease. Nevertheless, approximately half of all patients remain without a causal diagnosis. At present, targeted causal therapy...

Genová léčba v neurologiiEditorial

doc. MUDr. Hana Ošlejšková, Ph.D.

Neurol. praxi. 2026;27(2):83

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

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.

Diagnostic procedure in a patient with tremorFrom symptom to diagnosis

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.