Slovo úvodem

prof. MUDr. Ivan Rektor CSc

Neurol. praxi. 2009;10(3):131  

Chronické míšní poranění

doc. MUDr. Ivana Štětkářová CSc

Neurol. praxi. 2009;10(3):136  

Risk conditions in patients at chronic stage of spinal cord injury

MUDr. Jiří Kříž, MUDr. Veronika Hyšperská

Neurol. praxi. 2009;10(3):137-142  

For most patients with spinal cord injury initial medical care is provided by spinal units or spinal rehabilitation units. However, quality care should also continue in a chronic stage where it can be provided by a specialist or a well trained general practitioner. Spinal lesions are often accompanied by various complications that mostly does not require a different approach than in non-injured population. Nevertheless these complications often show poor symptomatology which can entail their missed or late diagnosis. Frequent complications in spinal injury are e.g. spasticity, autonomic dysreflexia or neuropathic pain. Impaired vitality of the...

Examination and rehabilitation procedures in patients after spinal cord lesion

MUDr. Jiří Kříž, MUDr. Šárka Chvostová

Neurol. praxi. 2009;10(3):143-147  

The physiotherapy of the spinal cord injuries takes, due to its high demands in costs, skills and specific needs, place at the specialized wards – the Spinal cord units. With respect to those requirements the special ASIA neurological assessment (performed according to the American Spinal Injury Association, ASIA) has been currently used. This examination permits an assessment of the level and extent of the neurological impairment. The rehabilitation begins immediately the SCI patients are admitted to the SCU. The main attention is paid to the respiratory and pain management. A wide range of specific physiotherapy methods have been used in...

Treatment of spasticity in chronic spinal cord injury

doc. MUDr. Ivana Štětkářová CSc

Neurol. praxi. 2009;10(3):148-152  

Severe spasticity and painfull muscle spasms worsen quality of life, mobility and self-care in patients suffered form chronic spinal cord injury. Poorly managed spasticity leads to serious long-term complications such as pressure sores, chronic pain, infections and fixed muscle contractures. Ashworth scale of muscle hypertonia, frequency of muscle spasms and visual analogue scales are the most common ones used in clinical practice for evaluation of spasticity. The most common treatment of spasticity is oral drug therapy (benzodiazepines, tizanidine, and baclofen). A local administration of botulinum toxin is suitable for focal spasticity in a small...

Pain diagnosis and treatment in patients after spinal cord injury - our experience

MUDr. Veronika Hyšperská, MUDr. Jiří Kříž

Neurol. praxi. 2009;10(3):153-159  

Spinal cord injury is often accompanied by pain. Prior to treatment it is always necessary to establish a correct diagnosis. In his classification, Siddall distinguishes between nociceptive and neuropathic pain. Nociceptive pain can be further divided into musculoskeletal and visceral subtypes. The pain originates most commonly from overloaded muscles and joints or from dysfunctional inner organs. If the cause is correctly diagnosed, treatment is usually successful. Neuropathic pain originates directly from the spinal cord or its roots above, at or below the lesion. It is often intractable and long-lasting and may in some cases lead to psychic...

Taking care of urine and stool passage in patients with complete spinal cord lesion

MUDr. Martin Sutorý, CSc, prof. MUDr. Peter Wendsche, CSc

Neurol. praxi. 2009;10(3):160-164  

Bladder atonia and areflexia are functional consequences of spinal shock following SCI. Sphincters are inactive, voiding is not possible. The bladder is distended. During this acute phase the therapeutic aim occurs in ensuring of the urine derivation preventing complications. Following procedures are used: permanent indwelling catheter, suprapubic drainage, intermittent cathe terization, reflex voiding by bladder tapping and suprapubic manual pressure. First days after injury on the ICU, a permanent indwelling catheter is used, later on changed to suprapubic drainage. It is recommended to change to intermittent catheterization as early as possible....

Cognitive dysfunction in multiple sclerosis

MUDr. Michal Dufek

Neurol. praxi. 2009;10(3):165-171  

Cognitive function impairment is common in patients with multiple sclerosis. Particularly affected are attention, speed of processing of information, and short-term memory. The cognitive deficits adversely affect social relations as well as quality of life and are the most common cause of job loss. The severity of the cognitive deficits correlates with the pathology seen on conventional magnetic resonance imaging (lesion extent, atrophy). Mostly mild forms are encountered, dementia is rare. Cognitive dysfunction may occur very early in the course of the disease and does not correlate with the physical impairment or the duration of the disease....

Headache diagnosis and treatment in the Czech Republic

MUDr. Jolana Marková

Neurol. praxi. 2009;10(3):172-178  

In the introduction, the author describes the history of the Czech Headache Society which has played an important role in developing the knowledge of headaches in the Czech Republic. Next, the IHS headache classification is briefly mentioned and an overview is given of the most commonly occurring primary as well as secondary headaches – migraine, tension headache, cluster headache syndrome, headaches related to head and/or neck injury, headaches related to cerebrovascular disease, headaches related to intracranial involvement of other than vascular aetiology, headaches related to the use or discontinuation of a pharmacologically active substance,...

Adult-onset huntington disease phenocopies

MUDr. Martin Kucharík, MUDr. Jiří Klempíř, Ph.D, doc. MUDr. Jan Roth CSc

Neurol. praxi. 2009;10(3):180-183  

Huntington´s disease (HD) is a well-defined autosomal dominant neurodegenerative disease. It is caused by CAG repeat expansions in huntingtin gene. There are a significant number of HD cases where this mutation was not found and such cases are named HD-like phenotype (HDL) or HD phenocopies. The aim of our work is to review these HDL. We studied existing resources and further we describe these syndromes, including HDL1, HDL2, and HDL4 (SCA17), and also (because of phenotypic overlap) dentatorubral-pallidoluysian atrophy, Friedreich‘s ataxia, neuroferritinopathy and neuroacanthocytosis.We also bring our proposal for diagnostic process, to...

Current trends in diagnosing and treatment of neuroborreliosis

MUDr. Ladislav Gurčík

Neurol. praxi. 2009;10(3):184-190  

Currently, Lyme borreliosis is the most common tick-borne disease in our country. For a vector-to-human transmission to occur, an infected tick has to be attached for at least 12–24 hours. The disease may frequently be manifested by nonspecific symptoms, which may commonly result in misdiagnosis. In particular stages of borreliosis, many patients may present with both typical and atypical symptoms. In the first stage, approximately 60 % of infected individuals present with erythema migrans (EM), other typical symptoms include headache, joint ache, muscle ache, and fatigue. The second stage of early disseminated infection follows several weeks...

Clinical case: Teratoma in the caudal region

MUDr. Marek Macejka, MUDr. Marian Starý, MUDr. Robert Kroupa, MUDr. Jan Síla

Neurol. praxi. 2009;10(3):192-194  

The authors present a rare clinical case of a 41-year-old patient with a spinal teratoma in the caudal region which manifested as sphincter difficulties. Following previous graphic examinations and the assessment of the intraoperative finding, the tumour was managed with endocapsular extirpation. A histological examination confirmed the finding of a mature teratoma. In the discussion, the authors briefly present the knowledge concerning the aetiopathogenesis and therapy for spinal teratoma.

Publikujeme v zahraničí

Neurol. praxi. 2009;10(3):195  

V. sympozium o léčbě bolesti, Brno, hotel Voroněž, 3.-4. 4. 2009

MUDr. Jiří Mastík, prof. MUDr. Pavel Ševčík CSc

Neurol. praxi. 2009;10(3):196-197  

XI. NEUROSKI Harrachov 2009

MUDr. Radomír Taláb CSc

Neurol. praxi. 2009;10(3):198