Slovo úvodem

prof. MUDr. Ivan Rektor, CSc.

Neurol. praxi. 2011;12(5):299  

Delirium: častý, závažný a opomíjený problém

doc.MUDr.Jan Roth, CSc., editor hlavního tématu

Neurol. praxi. 2011;12(5):303  

Delirium - a general introduction

MUDr.Tereza Uhrová, MUDr.Jiří Klempíř

Neurol. praxi. 2011;12(5):304-306  

Delirium is a clinical syndrome characterized by an acute attention deficit and cognitive dysfunction. It occurs frequently in hospitalized individuals, and its incidence rises with increasing age and severity of somatic condition. Diagnosis of delirium is based on history, clinical observation of behavior and testing of cognitive functions. The most common and important risk factor for development of delirium is the presence of dementia. In neurological practice, especially delirium occurs in dementia, as well as in stroke, CNS infections, tumors, etc.; administered drugs are also a frequent cause of delirium.

Treatment of delirium

doc.MUDr.Ján Pečeňák, CSc.

Neurol. praxi. 2011;12(5):307-310  

Delirium is a universal pathological reaction of brain to different noxious factors. The treatment is complex and often complicated. It must start early and to be oriented both to the primary factor (disease) and to the symptoms of delirium. The most often used drugs in the treatment of delirium are antipsychotics, particularly haloperidol and tiapride. Atypical antipsychotics are used with consideration of their pharmacological profiles. Risperidone and olanzapine are mostly used for this indication. Benzodiazepines should not be systematically applied for treatment of delirium, except in the case of alcohol dependence and delirium with seizures....

Delirium in geriatric patients

MUDr.Pavel Ressner, Ph.D., MUDr.Jiří Konrád, MUDr.Petra Bártová, Ph.D.

Neurol. praxi. 2011;12(5):311-316  

Delirium is a syndrome which, in geriatric patients, may lead to a significant functional impairment or even death. It is an acute, lifethreatening condition which occurs in elderly patients, particularly those in hospital. An elderly patient is extremely fragile and there is a high risk of delirium in patients with dementia, followed by those generally compromised, with the presence of an infection, or in postoperative states. It has been reported that up to 20% of all hospitalized patients over 65 years of age may develop complications during hospitalization as a result of delirium. A number of factors are involved in the development of delirium,...

Delirium in addictions to addictive substances

MUDr.Olga Pecinovská

Neurol. praxi. 2011;12(5):317-320  

Delirium is an acute, life-threatening condition requiring a timely diagnosis, a timely differential diagnosis to distinguish it from similar life-threatening conditions and a timely treatment. Delirium tremens is among the leading causes of death among those with a psychiatric diagnosis; however, the risk of delirium complications is still underestimated. The treatment of milder, uncomplicated deliria is feasible in conventional detoxification centres or at psychiatric wards through collaboration between a psychiatrist and an internist. The treatment of severe deliria and deliria in patients with serious somatic complications comes within...

Primary progressive multiple sclerosis - diagnosis, clinical aspects and treatment

MUDr.Ladislav Gurčík, PhD.

Neurol. praxi. 2011;12(5):321-328  

Primary progressive multiple sclerosis (PPMS) accounts for approximately 10–15% of cases of multiple sclerosis. The pathophysiology of the disease has not been elucidated yet; a pathogenetic background different from that in relapsing-remitting MS is assumed, i.e. more neurodegeneration, less inflammation. The current diagnostic criteria for definitive PPMS include clinical progression lasting at least one year, a positive MRI finding and intrathecal synthesis of immunoglobulin G and/or a positive oligoclonal banding in the cerebrospinal fluid. Currently, there are no guidelines on the treatment of PPMS. Because of inconclusive results...

Neuropathic pain - a frequent component of many diseases

prof.MUDr.Zdeněk Ambler, DrSc.

Neurol. praxi. 2011;12(5):329-333  

Neuropathic pain is defined as a pain arising as a direct consequence of a lesion or disease affecting the somatosensory system. A convenient classification of neuropathic pain is anatomical, according to the site of initiating nervous system pathology, with an etiological sub-classification. Where possible it should be divided into peripheral or central neuropathic pain based on the location of the lesion in the nervous system. In certain disorders pain could be of mixed type with both nociceptive and neuropathic components. Neuropathic pain is a very common problem in many neurological diseases. It may arise from a heterogeneous group of...

Secondary headaches in clinical practice

MUDr.Rudolf Kotas, Ph.D., MUDr.Jan Kastner, MUDr.Jiří Polívka, CSc.

Neurol. praxi. 2011;12(5):334-338  

The paper deals with secondary headaches. Secondary headaches are symptoms of a certain structural lesion or organic disorder intraor extracranially or they may be the manifestation of a metabolic disorder, application or removal of a certain substance. The paper focuses on serious life or health – threatening secondary headaches and their characteristic features. They are divided in several groups: headaches associated with vascular disorders, posttraumatic headaches, headaches associated with space – occupying lesions, with infection, and disorders of eye, nose and paranasal sinuses. The paper is completed with 9 case reprorts....

Current treatment of vestibular disorders

doc.MUDr.Jaroslav Jeřábek, CSc., MUDr.Petra Kalitová

Neurol. praxi. 2011;12(5):340-343  

Establishment of a proper diagnosis and therapy of vestibular patology requires interdisciplinar approach. There are some diseases such as Méniére´s disease or BPPV, which have defined diagnostic crietria and guidelines for treatment.It is necessary to know, that the most of patients who are visiting specialists has atypical symptoms not easy to interpret. We present a current situation of a treatment of vestibulat disorders in Czech republic ad we try to compare recommended guidelines with analysis of situation of vestibular therapy in Czech republic, which is based on survey of effectiveness of treatment dizzy patient over 6 months.

Restless legs syndrome and periodic limb movement disorder in childhood

MUDr.Iva Příhodová, Ph.D.

Neurol. praxi. 2011;12(5):344-347  

Restless legs syndrome (RLS) and periodic limb movement disorder are classified as sleep related movement disorders. They are connected with difficulty in falling asleep, repeated nocturnal awakenings and chronic sleep deprivation. Sleep deprivation in childhood causes mainly attention disorders, hyperactivity, mood changes and school failure. Symptoms can mimic attention-deficit/hyperactivity disorder (ADHD). Children with insomnia, daytime fatigue and ADHD symptoms should be systematically screened for these sleep disorders because anamnestic data could be unremarkable. Nocturnal polysomnography is useful tool for the diagnosis. Treatment...

Current status and perspectives of treatment for brain metastases

MUDr.Markéta Pospíšková, MUDr.Milan Kohoutek, MUDr.Michaela Zábojníková

Neurol. praxi. 2011;12(5):348-351  

Brain metastases are the most common intracranial neoplasms. The incidence of brain metastases is rising due to earlier detection, more effective imaging modalities and more effective treatment of systemic disease. The median survival of these patients is without treatment one month, corticosteroids can extend median survival to 2 months and radiotherapy to 3–6 months. The gold standard was WBI, but in the last 20 years are most often used stereotactic radiosurgery and stereotactic radiotherapy and neurosurgery for solitar lesions with improving median survival to 16 months. The goal of my work is to review important treatment modalities...

Is dementia diagnosed and treated correctly and timely? Results of a survey in the light of new recommendations

MUDr.Martin Vyhnálek, doc.MUDr.Aleš Bartoš, Ph.D., MUDr.Václav Dostál, MUDr.Vanda Franková1, doc.MUDr.Iva Holmerová, Ph.D., MUDr.Jan Laczó, Ph.D., MUDr.Vladimír Línek, doc.MUDr.Irena Rektorová, Ph.D., MUDr.Pavel Ressner, Ph.D., MUDr.Robert Rusina, MUDr.Kateřina Sheardová, MUDr.Martin Vališ, Ph.D., doc.MUDr.Jakub Hort, Ph.D.

Neurol. praxi. 2011;12(5):352-358  

A survey among 150 outpatient neurologists, psychiatrists and geriatricians aimed to ascertain the current practices in diagnosing and treating cognitive disorders in the Czech Republic. More than half of the patients with a cognitive disorder were diagnosed in moderately advanced and late stages. The results reveal insufficient use of imaging modalities for diagnosis. Most patients with the diagnosis of Alzheimer's disease are treated with cognitive enhancers. A widespread use of inefficient nootropics has been shown.

Myasthenia gravis - correlation with influenza vaccination

MUDr.Jana Junkerová, MUDr.Olga Zapletalová, MUDr.Jan Živný, Ph.D.

Neurol. praxi. 2011;12(5):359-362  

We present a case of aged married couple with generalized myasthenia gravis (MG). Clinical diagnosis was supported by EMG findings and evidence of antibody production against acetylcholin receptors. Myasthenia gravis clinically manifested several weeks after vaccination against influenza and subsequent viral infection with fever in both patients. The failure of immune tolerance and the development of organ-specific autoimmune disease emerged in polymorbid individuals. We assume that both patients developed MG on the ground of pre-existing disorders of the immune system (hypothyroidism). Iatrogenic (immunization) or viral infection resulted...

Publikujeme v zahraničí

Neurol. praxi. 2011;12(5):372  

Antibodies against JC virus and stratification of the progressive multifocal leukoencephalopathy risk in patients

MUDr.Dana Horáková, Ph.D., prof.MUDr.Eva Havrdová, CSc.

Neurol. praxi. 2011;12(5):364-365  

with multiple sclerosis. Recommendations for a new diagnostic test – STRATIFY JCVTM Tysabri (natalizumab) is a monoclonal antibody proved to be very effective in a treatment of multiple sclerosis (MS). The drug has shown a very good tolerability, except in a rare viral infection, progressive multifocal leukoencephalopathy (PML). The common JCvirus is a causative agent of PML. Its seroprevalence in human population ranges between 50 and 60 %. It was reported for the first time in the year 2005 in two patients with MS. Until June 1, 2011, 133 cases of PML have been reported from the cohort of approximately 84 thousand patients treated...

Masarykova univerzita, Brno

doc.MUDr.Robert Kuba, Ph.D.

Neurol. praxi. 2011;12(5):368-370  

VI. sympozium o léčbě bolesti, Brno - hotel Voroněž - 29.-30. 4. 2011

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

Neurol. praxi. 2011;12(5):366-367  

Legal aspects of ordering medication by phone

JUDr.MUDr.Lubomír Vondráček, JUDr.Jan Vondráček

Neurol. praxi. 2011;12(5):363  

The authors briefly review the risks of ordering medication by phone and report the facts for which ordering medication by phone is not recommended.

Autodidaktický test 5/2011

Neurol. praxi. 2011;12(5):373-374