Neurology for Practice - Latest articles
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Jak efektivně převádět pacienty z nízkoúčinných DMT v léčbě roztroušené sklerózy?Information
Redakce
Neurol. praxi. 2026;27(4):336-338
MyoklonusEditorial
prof. MUDr. Michal Minár, PhD. – editor hlavního tématu
Neurol. praxi. 2026;27(4):256
Když se účinnost snoubí s efektivitou. BRIUMVI - nový impuls v léčbě roztroušené sklerózyZaznělo na
MUDr. Zuzana Zafarová
Neurol. praxi. 2026;27(4):328-334
Moravia's most famous neuroscientist, psychiatrist, and neuropathologist: Arnold Pick (1851-1924)From the History of Neurology
prof. MUDr. Petr Kaňovský, CSc., FEAN, prof. MUDr. Kateřina Menšíková, Ph.D., MBA,FEAN, MUDr. Lucie Tučková, prof. MUDr. Radoslav Matěj, Ph.D.
Neurol. praxi. 2026;27(4):321-326
Arnold Pick was born in 1851 into a merchant family in Velké Meziříčí, in the Moravian part of the Bohemian-Moravian Highlands. After completing secondary school in Jihlava, he studied at medical school in Vienna, where his teachers included Meynert, von Brücke, Rokitanský, Škoda, Billroth, von Heber, and other renowned physicians of the Vienna School. After graduation, he worked briefly at the Westphal Clinic in Berlin, and spent two years as a staff physician at the mental health facility in Wehnen. In 1877, he moved to a German psychiatric clinic in Prague, which was located in buildings in Kateřinská Street. In 1880, he was offered a position at...
Adynamická afázie jako projev levostranného paramediánního thalamického iktuCases
MUDr. Patrik Nejl, MUDr. Jiřina Řezáčová, prof. PaedDr. Zsolt Cséfalvay, PhD., prof. MUDr. Robert Rusina, Ph.D.
Neurol. praxi. 2026;27(4):319-320 | DOI: 10.36290/neu.2026.027
A rare case of progressive mitochondrial disease in childhood: a case reportCase report
MUDr. Stanislava Suroviaková, PhD., MUDr. Adam Markocsy, PhD., MUDr. Matúš Igaz, MUDr. Otília Petrovičová, PhD., MUDr. Vladimír Zoľák, PhD., MUDr. Babeta Hofericová, prof. MUDr. Peter Bánovčin, CSc., prof. MUDr. Miloš Jeseňák, PhD., MBA, Dott. Ric., MHA
Neurol. praxi. 2026;27(4):313-318 | DOI: 10.36290/neu.2025.075
Mitochondrial diseases are caused by dysfunction of mitochondrial DNA or its regulatory mechanisms. Mutations in the POLG gene, encoding mitochondrial DNA polymerase gamma, are the most common genetic cause of these disorders, leading to a broad spectrum of phenotypes. One of the most severe manifestations is Alpers-Huttenlocher syndrome (AHS), characterized by refractory epilepsy, progressive encephalopathy, and hepatic insufficiency. In this article, we present a case study of a 6-year-old female patient with a genetically confirmed homozygous POLG mutation who experienced a sudden onset of focal seizures with rapid neurological deterioration....
When immunology turns into neurology: the case of a patient with common variable immunodeficiencyCase report
Matiiash Taras, prof. MUDr. Manuela Vaněčková, Ph.D., MUDr. Marta Vachová
Neurol. praxi. 2026;27(4):308-311 | DOI: 10.36290/neu.2025.043
In the first part of this article, we present a case of a patient with common variable immunodeficiency (CVID), who was admitted to the neurological department of Teplice district hospital due to rapid progression of gait disturbance. Neurological evaluation revealed apparent truncal ataxia and ataxia of the lower limbs, as well as a mild ataxia of the right upper extremity. MRI showed signs of cervical myelopathy, further investigation uncovered a gastric adenocarcinoma as the cause of a paraneoplastic syndrome. The patient's condition improved significantly after gastrectomy and treatment with prednisone. In the second part of the article, we provide...
Pain management in patients with rheumatic diseaseTrends in neuropharmacotherapy
MUDr. Jana Hrubešová
Neurol. praxi. 2026;27(4):303-307 | DOI: 10.36290/neu.2026.030
Pain is one of the most distressing symptoms of revmatology deseasess and, if not properly managed, can significantly reduce a patient's quality of life and limit their functional abilities. Effective pain management should be an essential part of a comprehensive treatment plan for patients with this condition. When standard analgesic treatments are insufficient, minimally invasive techniques may be considered, offering rapid and effective pain relief when appropriately indicated.
Tuberous sclerosis complex - neurological aspects, diagnosis and modern treatmentTrends in neuropharmacotherapy
MUDr. Jan Kubek, MUDr. Eva Březinová, Ph.D., MUDr. Edita Marvanová, MUDr. Marta Pažourková, doc. MUDr. Irena Doležalová, Ph.D.
Neurol. praxi. 2026;27(4):295-302 | DOI: 10.36290/neu.2026.050
Tuberous sclerosis complex (TSC) is an autosomal dominant multisystem disorder caused by mutations in the TSC1 and TSC2 genes. The disease is characterized by the formation of hamartomatous lesions in various organs, particularly the central nervous system, skin, kidneys, heart, and lungs. Neurological manifestations may represent a major determinant of morbidity and long-term prognosis. The most common neurological manifestation is epilepsy, which occurs in up to 80-90% of patients and is frequently drug-resistant, with a risk of status epilepticus and SUDEP (sudden unexpected death in epilepsy). Neurodevelopmental disorders, autism spectrum disorders,...
Getting the diagnosis right in adults with childhood-onset epileptic encephalopathies: Lennox-Gastaut and Dravet syndromes-lessons from clinical practiceReview articles
MUDr. Lucia Šmahovská, MUDr. Jitka Kočvarová, MUDr. Ondřej Strýček, Ph.D., MUDr. Klára Štillová, Ph.D., prof. MUDr. Milan Brázdil, Ph.D., doc. MUDr. Irena Doležalová, Ph.D.
Neurol. praxi. 2026;27(4):284-290 | DOI: 10.36290/neu.2026.055
Dravet syndrome (DS) and Lennox-Gastaut syndrome (LGS) belong to the most severe developmental and epileptic encephalopathies, characterized by early onset, a lifelong disease course, and a high degree of drug-resistance. Both syndromes are associated with substantial cognitive, behavioral, and functional impairment, as well as an increased risk of serious complications. In recent years, syndrome-specific therapeutic options have expanded considerably. For both DS and LGS, fenfluramine and cannabidiol have become available as targeted treatment options, demonstrating remarkable efficacy in randomized clinical trials. The aim of this review is to summarize...
Functional jerks: diagnosis, communication of the diagnosis, and treatmentMain topic
doc. MUDr. Tereza Serranová, Ph.D.
Neurol. praxi. 2026;27(4):278-283 | DOI: 10.36290/neu.2026.048
Functional jerks (myoclonus) are among the less common subtypes of functional movement disorders and manifest as rapid, mostly paroxysmal involuntary movements. They may be spontaneous, present at rest, triggered by action, or elicited by external stimuli; they preferentially affect the trunk, limbs, and neck. The diagnosis is based primarily on positive signs of inconsistency of the jerks, such as variability in the pattern of muscle activation, duration, and triggering factors, and on neurophysiological evidence of cortical correlates preceding the jerks in EEG-EMG back-averaging studies. In treatment, the key elements are delivering a positive...
Myoclonus - treatment: from rational pharmacotherapy to deep brain stimulationMain topic
doc. MUDr. Marek Baláž, Ph.D., MUDr. Pavel Ressner, Ph.D., prof. MUDr. Jan Chrastina, Ph.D., MUDr. Jonáš Kunst
Neurol. praxi. 2026;27(4):273-277 | DOI: 10.36290/neu.2026.051
The basis of successful myoclonus treatment lies in diagnosing the underlying causes, particularly ruling out drug-induced forms and metabolic disorders. The mainstays of symptomatic therapy are levetiracetam, valproate, and clonazepam, often in combination, while in drug-resistant cases, particularly in myoclonic dystonia, deep brain stimulation (DBS), most commonly targeting the globus pallidus internus, represents a significant therapeutic alternative. In focal forms, long-term therapy involves the administration of botulinum toxin.
The role of neurophysiology in the diagnosis of myoclonusMain topic
prof. MUDr. Michal Minár, PhD.
Neurol. praxi. 2026;27(4):268-272 | DOI: 10.36290/neu.2026.047
Myoclonus represents a heterogeneous group of hyperkinetic disorders characterized by sudden, brief muscle jerks. Precise classification according to the generator (cortical, subcortical, spinal, peripheral, or functional) is crucial for both diagnosis and treatment; however, clinical differentiation is often challenging. Diagnosis becomes even more complicated when myoclonus occurs in conjunction with another hyperkinetic disorder, for example in cervical dystonia or in typical or atypical parkinsonian syndromes. Electrophysiological methods, particularly polymyography (poly-EMG), electroencephalography (EEG), somatosensory evoked potentials (SSEP),...
Myoclonus - basic orientation for clinical practiceMain topic
MUDr. Ján Necpál, PhD., MUDr. Orest Shabatiuk
Neurol. praxi. 2026;27(4):263-267 | DOI: 10.36290/neu.2026.039
Myoclonus, belonging to the group of hyperkinetic movement disorders, is manifested by short and rapid muscle jerks, caused by their active contraction, or by a sudden loss of muscle activity. Myoclonus is caused by a number of different causes, which may have different anatomical correlates. However, a detailed history, clinical examination, neuroimaging methods and knowledge of neurophysiological testing can often narrow the diagnostic perimeter to a specific disease and thus significantly accelerate the diagnostic process. Within this framework, it is always necessary to first think about the exclusion of potentially reversible causes.
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...