Slovo úvodem

prof. MUDr. Ivan Rektor, CSc.

Neurol. praxi. 2011;12(6):379  

Imunoterapia v neurológii

doc.MUDr.Peter Špalek, PhD.&ndash, editor hlavního tématu

Neurol. praxi. 2011;12(6):383  

Basic principles of corticosteroid treatment in autoimmune neuromuscular disorders

doc.MUDr.Peter Špalek, PhD.

Neurol. praxi. 2011;12(6):384-388  

Corticosteroids are the most widely and frequently used immunomodulatory agents. The immunosuppressive and anti-inflammatory effects of corticosteroids have several components. Corticosteroids induce peripheral blood neutrophilia, whereas T-cells, monocytes, and eosinophils are depleted from blood. Steroids alter functional properties of T-cells and monocytes, act on synthesis and secretion of cytokines and immune mediators, and have effect on microvascular permeability. For autoimmune neuromuscular diseases treatment with corticosteroids can be extended over many years (e.g., myasthenia gravis, polymyositis, dermatomyositis, CIDP, etc), for...

Immunosuppressive drugs in treating neurological diseases

MUDr.Jiří Piťha

Neurol. praxi. 2011;12(6):389-393  

Immunosuppressive drugs have been used in the practice for more than fifty years. In treating neurological autoimmune diseases, their role is irreplaceable. Azathioprine, cyclophosphamide, methotrexate, mycophenolate mofetil, mitoxantrone, cyclosporin A and tacrolimus have been particularly used; clinical trials with cladribine and teriflunomide are under way. The paper deals with the mechanism of action, adverse events and therapeutic regimens of individual agents; also covered are the indications of immunosuppressive drugs in the most common autoimmune diseases. During treatment, it is always necessary to weigh the benefits against risks,...

Therapeutic plasma exchange in the treatment of autoimmune neuromuscular disordes

prof.MUDr.Josef Bednařík, CSc.

Neurol. praxi. 2011;12(6):394-397  

The aim of therapeutic plasma exchange (TPE) is to remove pathological (autoantibodies, monoclonal proteins, toxins bound to plasma proteins) or increased physiological plasma components (cytokins, kinins). Among neurological diseases, TPE is the accepted first-line therapy (according to American Society for Apheresis [ASFA] – category I) in PANDAS („Pediatric Autoimmune Neuropsychiatric Disorders Associated with streptoccal infections and Sydenham’s chorea“), and the second-line therapy (category II) in acute disseminated encephalomyelitis, multiple sclerosis, Devic disease and some paraneoplastic neurological syndromes...

Intravenous immunoglobulin therapy for autoimmune neurological disorders

doc.MUDr.Peter Špalek, PhD.

Neurol. praxi. 2011;12(6):398-402  

Intravenous immunoglobulins (IVIg) have been used for treating various neuroimmunological diseases. Over the past years their efficacy could be demonstrated in placebo-controlled, double-blinded clinical trials. Use of IVIg has become the first-line treatment for Guillain-Barré syndrome, multifocal motor neuropathy, chronic inflammatory demyelinating polyneuropathy, and rapidly worsening myasthenia gravis. Furthermore, IVIg plays an important role as a second-line treatment in selected chronic treatment-refractory cases of polymyositis, dermatomyositis, Lambert-Eaton myasthenic syndrome, stiff-person syndrome, and also in postpartum-related...

The use of monoclonal antibodies in neurology

prof.MUDr.Egon Kurča, PhD., MUDr.Mária Cuninková

Neurol. praxi. 2011;12(6):403-406  

Monoclonal antibodies currently represent one of the highest stages of pharmacological development. In contrast to previous opinions, it seems that they will be applied not only to treat autoimmune diseases, but their real clinical use will obviously be broader including, for example, tumour-related problems. The review article provides current information on the real and potential use of monoclonal antibodies in neurological diseases.

How to reach remission in epilepsy patient

doc.MUDr.Petr Marusič, Ph.D., MUDr.Hana Krijtová

Neurol. praxi. 2011;12(6):407-410  

Seizure freedom is one of the main goals of therapy in epilepsy patients as it is associated with significant quality of life improvement. There is still no consensual definition of seizure remission regarding the period of its duration. For patients, long-life remission is definitely the most acceptable. The way how to reach seizure freedom starts with initial monotherapy with adequately chosen antiepileptic drug. Most of the patients but not all are responding to moderate or even modest dosing, in some higher or maximal dosing is necessary to reach the full benefit. In initial monotherapy failure the further step is alternative monotherapy...

Normal pressure hydrocephalus

MUDr.Václav Vybíhal

Neurol. praxi. 2011;12(6):411-417  

Normal pressure hydrocephalus is a special type of communicating hydrocephalus characterised by the classic clinical triad of gait disturbance, dementia, and urinary incontinence. Magnetic resonance imaging plays the main role in the field of imaging methods and it is useful in differential diagnosis, too. Tap test, lumbar infusion test and external lumbar drainage belong to the most frequently used tests in the selection of patients for operative treatment. Based on the clinical state of a patient, findings of the imaging methods, results of the supplemental tests, and also taking into account the co-morbidities and surgery risks, patients...

Prevention of dementia and lifestyle

MUDr.Kateřina Sheardová, MUDr.Daniel Hudeček

Neurol. praxi. 2011;12(6):418-421  

Reduced cognitive ability and dementia significantly affect the quality of life in elderly people, including their carers. Therapeutic options have been limited so far; therefore, preventive strategies reducing the risk of developing dementia are being intensively sought. In this regard, healthy lifestyle has been increasingly discussed. This paper summarizes the current knowledge on the lifestyle components most commonly investigated in association with dementia; in particular, eating habits, alcohol, smoking, physical activity, education and cognitive stimulation, spirituality, and social involvement. The effect as well as the potential mechanisms...

News in the treatment of diabetic neuropathy

MUDr.Dana Halbichová

Neurol. praxi. 2011;12(6):422-425  

Diabetes mellitus and the treatment of associated complications is a great problem oll over the world. Modern medicine offeres a wide range of therapeutical possibilities. There are some new drugs in clinical praxis, some are not registrated in Czech republic or their indication is out off label. Non- pharmaceutical methods can be used as alternative treatment of diabetic neuropathy.

Dysphagia screening in neurology: the nurse’s role

Petra Mandysová MSN, doc.MUDr.Edvard Ehler, CSc.

Neurol. praxi. 2011;12(6):426-429  

Dysphagia is a symptom that accompanies a number of neurological conditions. To diagnose dysphagia, a screening assessment focused on swallowing may be used. The article describes the multidisciplinary approach to swallowing disorders, focusing on the role of nurses in the development and implementation of screening tools in a practice setting. The article provides examples of screening tools, and at the same time, selected pitfalls associated with their development and implementation are discussed.

Correlation of MхA mRNA expression with NAbs levels in patients with multiple sclerosis

MUDr.Václav Maťoška, MUDr.Jana Libertínová, Mgr.Tereza Kumstýřová, Mgr.Miroslav Zajac, MUDr.Eva Meluzínová, Mgr.Zuzana Lacinová, MUDr.Aleš Tomek, MUDr.Luděk Táborský

Neurol. praxi. 2011;12(6):430-433  

Myxovirus resistance protein A (MxA) belongs to dynamin superfamily. MxA is a component of antiviral response and is solely induced by interferons, thus by in vivo application of interferon β (INFβ) as well. In patients with multiple sclerosis (MS), neutralizing antibodies (NAbs) appearing during INFβ treatment in 10–30 % of cases, decrease its bioactivity and therapeutic efficacy. The aim of this study was to show the correlation of MxA and Nabs levels on the cohort with relaps-remitting form of MS (RR-MS) and to set up the cutoff value for the baseline levels of MxA in population. The cohort sustained of 16 NAbs positive,...

Improvement of motor functions evaluated by GMFM after robotic- assisted treadmill training in two patients with cerebral palsy

MUDr.Stanislava Klobucká, prof.MUDr.Michal Kováč, CSc., PhDr.Elena Žiaková

Neurol. praxi. 2011;12(6):434-442  

In this paper we present a robotic-assisted locomotor therapy in LOKOMAT system and report here the results of a 12-week trial of robotic- assisted treadmill therapy in the LOKOMAT system of a 5,5 year and 25 year old patients both suffering from quadriplegia form of cerebral palsy. The aim of the treatment was to improve motor function, stability of sitting, standing and if possible also improvement of walking parameters. Before and after therapy the patients were examined and tested in a standard way through a range of GMFM. In both cases we have documented significant improvement in stabilization of the axial muscle tone. We have recorded improvement of...

Neurologové se ptají...

Neurol. praxi. 2011;12(6):444  

Noncompliance and its legal aspects

JUDr.MUDr.Lubomír Vondráček, JUDr.Jan Vondráček

Neurol. praxi. 2011;12(6):443  

The authors deal with the legal issues brought about by providing health care to noncompliant patients and with their possible solutions.

Autodidaktický test 6/2011

Neurol. praxi. 2011;12(6):445-446