Slovo úvodem

prof. MUDr. Ivan Rektor, CSc.

Neurol. praxi. 2011;12(3):151  

Editorial

MUDr.Pavel Diblík -, editor hlavního tématu

Neurol. praxi. 2011;12(3):155  

Optic neuritis in patients with multiple sclerosis - characteristic features, differential diagnosis and diagnostic challenges

MUDr.Pavel Diblík, MUDr.Pavel Kuthan, MUDr.Petr Sklenka

Neurol. praxi. 2011;12(3):156-159  

Multiple sclerosis (MS) or suspicion of MS are relatively common findings in neurological clinics, prevalence of MS in Czech republic is 100–130/100 000 inhabitans. As optic neuritis is often the first sign of MS, close collaboration among ophthalmologists and neurologists is needed. The aim of this study was to demonstrate typical clinical presentation of optic neuritis affecting MS patients based on individual signs and symptoms. We also provide practical set of differential diagnostic rules and show possible challenges in the diagnostic process. We conclude that making a correct diagnosis requires taking a detailed medical history...

Temporal arteritis - an acute condition reguiring emergency care

MUDr.Pavel Kuthan, MUDr.Pavel Diblík, MUDr.Petr Sklenka, MUDr.Aneta Klímová

Neurol. praxi. 2011;12(3):160-163  

Temporal arteritis (TA) is an inflammatory vasculopathy of old people. Neurologic manifestations include headaches, memory disturbances, and dementia; from the ophthalmologic point of view, it is sudden and irreversible decrease or loss of visual functions. The systemic manifestations include fatigue, scalp tenderness, night swelling, loosing the weight, intermittent claudication during mastication or walking, and pain of the muscles. The early diagnosis is mandatory for the beginning of the treatment; its delay may be also the cause of blindness. Clinically, the diagnosis is based on high, and otherwise without other reasons, ESR, or CRP as...

Idiopathic orbital inflammatory disease

MUDr.Aneta Klímová, MUDr.Pavel Diblík, MUDr.Pavel Kuthan, MUDr.Petr Sklenka

Neurol. praxi. 2011;12(3):164-166  

Idiopathic orbital inflammatory disease (IOID) is a relatively common disease – on average, 10 new patients a year are detected in our neuro-ophtalmologic departement alone. IOID is a non-infectious inflammation in the orbit, which behaves like a tumour clinically, but only signs of a chronic inflammation can be found histologicaly. The etiology of this disease is unknown. IOID can infiltrate any soft tissue in the orbit. It presents itself with various clinical symptoms, some of them can resemble any CNS disease. One should think of the diagnosis of IOID when eyelid oedema or ptosis and eye motility disorder is present. IOID is diagnosed...

Idiopatic intracranial hypertension - pseudotumor cerebri from an opthalmologist’s point of view

MUDr.Petr Sklenka, MUDr.Pavel Kuthan

Neurol. praxi. 2011;12(3):167-169  

Authors review the topic of idiopatic intracranial hypertension or pseudotumor cerebri from an ophthalmologist‘s point of view. Thus the article can not serve as a complete rewiew of the disease. The suspicion is often made by an ophthalmologist according to typical signs, especially papilledema. Neurological examination finds no patology, normal findings of imaging techniques are also typical. Etiology and pathogenesis still remains unclear. Therapy, if started early enough, can in most cases effectively prevent a visual loss. Authors add brief case reports.

Does the development of new drugs for multiple sclerosis change the prognosis of the patient?

prof.MUDr.Eva Havrdová, CSc.

Neurol. praxi. 2011;12(3):170-174  

We have disease modifying drugs (DMDs – interferon beta, glatiramer acetate) for the treatement of multiple sclerosis (MS) for 15 years in Czech Republic. Only 30 % of patients are full responders to this treatment, in the rest the effect is insufficient or partial.The only possibility for treatment escalation until 2008 was mitoxantrone (with only transient effect and serious adverse events). Since 2008 we can use the first monoclonal antibody in neurology, natalizumab, with doubled clinical efficacy in comparison with classical DMDs. Natalizumab has brought the concept of „freedom of disease activity“. New drugs which are...

Alzheimer’s disease and mild cognitive impairment: diagnosis and treatment

MUDr.Linda Čechová, doc.MUDr.Aleš Bartoš, Ph.D., MUDr.David Doležil, Ph.D., RNDr.Daniela Řípová, CSc.

Neurol. praxi. 2011;12(3):175-180  

Early recognition of the dementia syndrome is the most important part in the diagnostics of Alzheimer‘s disease. It is followed by determination of Alzheimer‘s disease as the most likely cause of it. A clinical transitional state between the normal ageing and dementia is referred to as mild cognitive impairment. The auxiliary diagnostic methods are not only used to rule out other causes of dementia, but they can directly support the diagnosis of Alzheimer‘s disease. The clinical trials have proved that current drugs slow the progression of the disease. We can use acetylcholinesterase inhibitors for treatment of mild to moderate...

Acute polyradiculoneuritis - differential diagnostics

doc.MUDr.Edvard Ehler, CSc., MUDr.Magdalena Derďáková, MUDr.Ján Latta, MUDr.Milan Mrklovský

Neurol. praxi. 2011;12(3):181-187  

Acute polyradiculoneuritis is an autoimmune-based neuropathy and represents an important diagnostic and therapeutic problem. In Europe demyelinating forms prevail (more than 80 %), whereas in China and in Middle and Southern America the axonal forms represent more important portion. During diagnosis setting there is necessary to evaluate clinical finding and a course of disease, then laboratory analysis of blood and urine follow, further electrophysiological investigations (motor and sensory neurography, F-waves, H-reflex) and withdrawal of cerebrospinal fluid. During differential diagnostic process there is to evaluate and differentiate a...

Epilepsy and metabolic syndrome X

MUDr.Irena Novotná

Neurol. praxi. 2011;12(3):188-190  

Metabolic syndrome is a common disease in all population groups. It is characterized by obesity, hypertension, hyperglycaemia, and hyperlipidaemia (Tung M Fong, 2004). The aetiology may be determined genetically; however, lifestyle factors play a major role, particularly excess caloric intake and sedentary lifestyle. The condition may be aggravated by some medications, e. g. antiepileptics, which are administered on a long-term basis in individuals with epilepsy. Thus, when selecting an antiepileptic drug, the patient's comorbidities have to be taken into consideration.

Therapeutic advances in hereditary muscular disorders

MUDr.Stanislav Voháňka, CSc., MBA

Neurol. praxi. 2011;12(3):191-195  

Treatment progress in hereditary neuromuscular disorders could be divided in two groups. Current multidisciplinary care and progress in gene and pathogetic oriented therapy. Multidisciplinary symptomatic care does not treat the principle of the disease, but it is very significant and improves the patient’s quality of life. Orthoses which can prolong the ambulatory stages, management of cardiac and pulmonary functions are considerable topics. Cardiac involvement is in some muscular dystrophies the prominent sign which can restrict the life length expectancy (Emery- Dreifuss muscular dystrophy, dystrophinopathy). To the symptomatic care...

Most fregment dementias and their treatment

MUDr.Richard Krombholz

Neurol. praxi. 2011;12(3):196-200  

In connection with dementia it is currently talked about a silent epidemic. In the Czech Republic there are currently according to some realistic estimates about 150 thousands people suffering from dementia, while the pessimists estimate up to about 200 thousand ill people. It is not within the power of a branch of medicine to take care for all these patients and the care of them is shared mainly with neurology, psychiatry and geriatrics. Particularly important for diagnostics and early treatment is the primary care. The author of the article focuses on the clinical picture, diagnostics and early treatment of the most common dementias, which...

Primary psoas abscess

MUDr.Věra Štěpánková, MUDr.Ján Latta, MUDr.Jan Hájek, doc.MUDr.Edvard Ehler, CSc.

Neurol. praxi. 2011;12(3):201-203  

Acute lumbago, with a backache that radiates into the thigh, has a broad differential diagnosis. Rational diagnostic and therapeutic procedure often requires a rather broad medical knowledge. We present a case report of a healthy 27-year-old man, who was admitted to the neurology department with the low back pain and projection to the left thigh lasting for eight days. Higher temperature, increased CRP (C-reactive protein) and clinical findings led us to suspect abscess of the psoas muscle. The abdominal CT confirmed the suspicion of an abscess and subsequent biopsy under CT navigation and drainage of the abscess led to a correct diagnosis....

Vertebrobazilární insuficience. Je termín vertebrobazilární insuficience stále aktuální?

prof. MUDr. Zdeněk Ambler, DrSc.

Neurol. praxi. 2011;12(3):204-206  

Klinický standard pro léčbu pacientů s autoimunitními nervosvalovými onemocněními intravenózním lidským imunoglobulinem a plazmaferézou - zkrácená verze

Josef Bednařík, Stanislav Voháňka, Edvard Ehler, Zdeněk Ambler, Jiří Piťha, Jiří Vencovský, Jiří Litzman, Zdeněk Kořístek, Miloš Suchý, Martina Pátá, Pavel Kožený

Neurol. praxi. 2011;12(3):207-209  

MUDr. Jan Hromada, sedmdesátiletý

prof. MUDr. Zdeněk Ambler, DrSc.

Neurol. praxi. 2011;12(3):210  

Profesor Lisý - svieži sedemdesiatnik

prof. MUDr. Peter Kukumberg, Ph.D.

Neurol. praxi. 2011;12(3):211-212  

Zpráva z pořádání XXVI. českých a slovenských dnů mladých neurologů a XIII. obnovených moravskoslovenských dnů v Přerově

MUDr.David Doležil, Ph.D.

Neurol. praxi. 2011;12(3):213  

Autodidaktický test 3/2011

Neurol. praxi. 2011;12(3):214-215