Slovo úvodem

prof. MUDr. Ivan Rektor, CSc.

Neurol. praxi. 2012;13(2):63  

Demence - úvod k hlavnímu tématu

doc. MUDr. Irena Rektorová, Ph.D.1, 2 - editorka hlavního tématu

Neurol. praxi. 2012;13(2):67  

New clinical criteria for diagnosing Alzheimer,s disease after 27 years

doc.MUDr.Irena Rektorová, Ph.D.

Neurol. praxi. 2012;13(2):68-71  

In this review article the new diagnostic guidelines for Alzheimer’s disease are reported. The recommended biomarkers that confirm the AD pathophysiological process are listed, however the use of these biomarker tests has not yet been advocated for routine diagnostic purposes at present time.

Vascular dementia and vascular cognitive impairment

doc.MUDr.Aleš Bartoš, Ph.D., RNDr.Daniela Řípová, CSc.

Neurol. praxi. 2012;13(2):72-77  

Vascular dementia and vascular cognitive impairment include a heterogeneous group of ischemic or hemorrhagic insult (s) of the brain resulting in cognitive impairment. Based on localization and an extent of vascular patology, manifestation can be either subcortical (namely dysexecutive syndrome and decreased psychomotor speed) or cortical (instrumental functions). Vascular etiology is supported by case history, certain neurological findings and results of brain CT or MR imaging. Treatment efforts should be focused on modification of vascular risk factors. Clinical studies showed an effect of acetylcholinesterase inhibitors even in VD. diagnosis,...

Prion diseases

MUDr.Robert Rusina, Ph.D., MUDr.Radoslav Matěj, Ph.D.

Neurol. praxi. 2012;13(2):78-82  

Prion diseases are caused by proteinous infectious particles, which are very resistant to usual sterilization procedures. The most current is Creutzfeldt-Jakob disease. Its diagnosis is based on clinical findings (rapidly progressive dementia, pyramidal or extrapyramidal involvement, myoclonus, visuo-spatial impairment and akinetic mutism) and positive 14–3–3 protein in CSF and/or periodic activity on EEG. MRI hyperintensities in FLAIR and diffusion weighted images in subcortical structures (putamen and caudate) and in some cortical areas, are currently being added to new WHO diagnostic criteria. Early recognition of a prion disease...

Drug-induced cognitive impairments

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

Neurol. praxi. 2012;13(2):83-86  

Although somewhat neglected and out of the main focus of recent medical literature, drug-induced cognitive impairments are a serious issue. The present paper aims to provide an overview of pharmaceuticals with potential risks of inducing cognitive impairments. Pharmaceuticals with anticholinergic effects and benzodiazepines are associated with the greatest risk. It is always appropriate to consider possible drug interactions and other risks resulting from the biological and metabolic status of a particular patient. Medications may interfere with cognition indirectly by affecting metabolism, such as in hypoglycaemia or drug-induced hyponatraemia;...

The postprocessing of MRI in patients with intractable epilepsy

MUDr.Martin Pail, Ing.Radek Mareček, prof.MUDr.Milan Brázdil, Ph.D.

Neurol. praxi. 2012;13(2):87-91  

Epilepsy is one of the most common neurologic disease. Despite the improvement of the neuroimaging methods several structural pathologies (especially malformations of the cortical development – MCD), which are in the clear-cut causation of disease, do not have to be detected by classical CT or MRI examination. Because visual evaluation of MRI remains difficult to detect some subtle abnormalities, several neuroimaging approaches, methods and modalities have been established to improve detection and localization of MCD. These methods are called in expert literature as a MRI postprocessing. (Jackson at al., 2010). This specific approaches...

Epilepsy and anxiety disordes

prof.MUDr.Milan Brázdil, Ph.D.

Neurol. praxi. 2012;13(2):92-96  

Among the psychiatric comorbidities in epilepsy, anxiety and anxiety disorders are ones of the most frequent. Mainly upon the epilepsy features these conditions occur in 10–50 % of patients. However in the shadow of epileptic seizures these problems have been mostly disregarded in the past. They were not properly diagnosed and treated. Withal they have a profound influence on the quality of life of epilepsy patients. This review focuses on occurrence of anxiety disorders, their early diagnostic and treatment recommendation for the epileptological practice.

Genetic aspects of „idiopathic“ epilepsies

MUDr.Štefania Rusnáková, RNDr.Lenka Fajkusová, CSc., Mgr.Eva Jansová, Mgr.Pavla Šultesová, Mgr.Marie Chovančíková, Ph.D., doc.MUDr.Robert Kuba, Ph.D., doc.MUDr.Hana Ošlejšková, Ph.D.

Neurol. praxi. 2012;13(2):97-100  

Nowadays we should suppose that epileptology come in the period of DNA and the genetics has become one of main trend of research in epileptology over the world. Epilepsies in which genetic background is predicted are called “idiopathic”. In recent years genetic discoveries have shown the central role of ion channels in the pathophysiology of idiopathic epilepsies. Ion channels are divided to voltage-gated and ligand-gated ion channels. For voltage-gated ion channels, mutation of Na+, K+ and Cl- channels are associated with forms of generalized epilepsy and infantile seizures syndromes. Mutations in ligand-gated ion channels, such...

Excessive daytime sleepiness in Parkinson‘s disease

MUDr.Marek Baláž, Ph.D., MUDr.Vilém Novák

Neurol. praxi. 2012;13(2):101-104  

Excessive daytime sleepiness (EDS) is an important non-motor symptom that decreases the quality of life of patients with Parkinson‘s disease. EDS limits the physical activity, ability to drive motor vehicles, worsens the social interactions and communication. The diagnosis of excessive daytime is based on careful assessment of sleep habits, presence of nocturnal sleep disruptions, complete drug history and in some cases polysomnography. The Epworth Sleepiness Scale provides a useful tool for evaluating the presence and severity of EDS. Appropriate diagnosis of the EDS can lead to timely treatment initiation. Therapy is usually symptomatic...

Alzheimer’s disease and type 2 diabetes mellitus

doc.MUDr.Miroslav Zeman, CSc., doc.MUDr.Roman Jirák, CSc.

Neurol. praxi. 2012;13(2):105-108  

Both the epidemiological data and results of experimental works have shown tight relations of the insulin resistance, type 2 diabetes mellitus (DM2), cognitive disturbances and sporadic form of Alzheimer´s disease. Plethora of events, standing behind these relations, is associated with an abnormal brain glucose metabolism. Some authors call Alzheimer‘s disease, „type 3 diabetes mellitus“. In the article, an outline is given on the mechanisms, connecting both the insulin resistance and DM2 with the cognitive disturbances or dementia. Some new potential possibilities of the favourable influencing of the sporadic form of Alzheimer´s...

Cranial neuropathy in a patient with Burkitt lymphoma infiltrating the cauda equina

MUDr.Martin Pail, MUDr.Ivica Husárová, MUDr.Marta Pažourková, MUDr.Eduard Minks

Neurol. praxi. 2012;13(2):109-111  

Burkitt lymphoma is a high grade B-cell hemathologic malignity and a subtype of Non-Hodgkin lymphoma. Primary leptomeningeal lymphoma is a rare syndrome, characterized by lymphomatous meningeal infiltration with no evidence of either systemic lymphoma or parenchymal central nervous system lymphoma. Malignant cells are found in the cerebrospinal fluid, within and around the meninges only, with no invasion of parenchymal tissue. The infiltration affects also peripheral and cranial nerves or spinal roots. Polyneuropathic syndrome is a common clinical manifestation of the disease. Nevertheless, the secondary metastatic invasion of the parenchymal...

Acute carpal tunnel syndrome in navicular bone fracture

MUDr.Radek Kaiser, prof.MUDr.Pavel Haninec, CSc.

Neurol. praxi. 2012;13(2):112-113  

Carpal tunnel syndrome is the most common compressive neuropathy of the upper extremities. Rarely, it can be acute, typically after an injury or less commonly in bleeding disorders. We present a case of 27-years old man with a fractured scaphoid bone with the development of acute carpal tunnel syndrome eight hours after the injury presented by anesthesia in the nerve innervation zone and severe pain in the carpal area. The patient felt relief immediately after the acute decompression of the nerve. Sensitivity and motor function of the hand has normalized in a couple of months.

GABRIEL: the implications of a study of prescribing patterns of physicians in treating

prof.MUDr.Ľubomír Lisý, DrSc., doc.MUDr.Ján Lietava, CSc., MUDr.Pavol Borecký, PhD.

Neurol. praxi. 2012;13(2):114-117  

painful forms of peripheral neuropathies with gabapentin Study background: Proper management of neuropathic pain is a major part of an outpatient neurologist's everyday practice. Despite an increasing range of active substances used for symptomatic treatment of painful forms of neuropathies of varying aetiology, it is a well-known fact that drugs are not used across the entire therapeutic dosage range and are often insufficiently dosed even in spite of good tolerance and failure to achieve desired relief. Purpose: The primary purpose of the non-interventional clinical trial was to assess the prescribing patterns of neurology specialists in...

Neurologové se ptají …

MUDr. Jan Klener

Neurol. praxi. 2012;13(2):118