Slovo úvodem

prof. MUDr. Ivan Rektor, CSc.

Neurol. praxi. 2013;14(1):3  

Paraneoplastické syndromy - úvod

prof. MUDr. Zdeněk Ambler, DrSc. - editor hlavního tématu

Neurol. praxi. 2013;14(1):6-7  

Paraneoplastic neurological syndromes - essential characteristics, classification, etiopathogenesis and diagnostics

doc.MUDr.Pavel Štourač, Ph.D., prof.MUDr.Zdeněk Ambler, DrSc.

Neurol. praxi. 2013;14(1):8-11  

Paraneoplastic neurological syndromes (PNS) are a heterogeneous group of disorders and may affect any part of the nervous system, neuromuscular junction and muscles. Evidence is increasing that most PNS are immune – mediated. The current concept is that the expression of neuronal proteins by a tumor provokes an immune response against both the tumor and the nervous system. A patient produces tumor-directed antibodies known as onconeural antibodies and because of antigenic identity, these onconeural antibodies attack components of the nervous system as well. Based on the clinical syndrome, the type of antibody, and the presence or absence...

Paraneoplastic neurological syndromes of central nervous system

doc.MUDr.Pavel Štourač, Ph.D., MUDr.Jana Bednářová, Ph.D.

Neurol. praxi. 2013;14(1):12-15  

Paraneoplastic syndromes of the central nervous system usually starting with subacute disease course require prompt diagnosis, which significantly influences therapeutical outcome. Knowledge of clinical pattern, associated onconeural antibodies and tumours may help with the early diagnosis. We present the profile of the most common paraneoplastic syndromes of the central nervous system within this continuously expanding disease group.

Paraneoplastic syndromes of peripheral nerves, neuromuscular junction and muscles

prof.MUDr.Zdeněk Ambler, DrSc.

Neurol. praxi. 2013;14(1):16-19  

Classical paraneoplastic syndromes (PNS) in the present group include subacute sensory neuronopathy (SSN), Lambert-Eaton myasthenic syndrome (LEMS) and dermatomyositis. Sensorimotor peripheral neuropathies, autonomic neuropathy, peripheral nerve hyperexcitability are less common. The symptoms of PNS may occur before the presence of systemic cancer is known, making diagnosis more difficult. SSN is the most common and characterized by primary damage of the sensory nerve cell body of the dorsal root ganglia but some patients can also have evidence of axonal and demyelinating neuropathy. A paraneoplastic origin is only one of the causes and anti-Hu...

Polyneuropathy

doc.MUDr.Edvard Ehler, CSc.

Neurol. praxi. 2013;14(1):20-27  

Polyneuropathy is a diffused or multiple systemic disorder of peripheral nerves. According to affected anatomic structure it is possible to differentiate axonal, demyelinating and mixed lesions. According to the affected type of fibres there are motor, sensory, autonomic, and combined lesions. In patient´s case history there are positive and negative signs and symptoms for all nerve fibre types. In clinical examination there are important not only extent and severity of the disorder, but also presence of disturbances of other systems. Besides electrophysiological investigations there is increasing importance of new possibilities in diagnostics...

Late complications of Parkinson's disease

MUDr.Václav Dostál

Neurol. praxi. 2013;14(1):28-32  

Parkinson's disease is one of the most common neurodegenerative diseases. It manifests with a classic triad of symptoms (tremor, hypokinesia, and rigidity). Establishing the diagnosis may be challenging and frequently takes several months. Dopamine replacement therapy is an effective treatment. The treatment works very well in the first few years; afterwards, however, late complications start to develop and include both motor and mental as well as autonomic ones. The disease is complex and cannot be limited to motor symptoms only. In the late stages, non- -motor symptoms often affect the quality of life of the patient and his family more than...

Lateralizing signs in temporal lobe epilepsy

MUDr.Klára Musilová, prof.MUDr.Robert Kuba, Ph.D.

Neurol. praxi. 2013;14(1):33-37  

In addition to advances in imaging and functional imaging techniques, intensive study of the semiology of ictal and post-ictal symptoms significantly contributes to major progress in the field of epileptology. Due to this, new signs with possible localizing and lateralizing value are being discovered the knowledge and recognition of which not only contributes to establishing the right diagnosis, but particularly to the correct detection of the epileptogenic zone during the course of assessment within an epilepsy surgery program. The present article provides an overview of lateralizing signs in patients with temporal lobe epilepsy.

Guidelines for sleep related breathing disorders treatment using positive airways pressure in adults

MUDr.Martin Pretl, CSc., MUDr.Milada Hobzová, Ph.D., MUDr.Monika Honnerová, MUDr.Jaroslav Lněnička, MUDr.Vilém Novák, MUDr.Vratislav Sedlák, MUDr.Jana Vyskočilová, prof.MUDr.Karel Šonka, DrSc.

Neurol. praxi. 2013;14(1):38-41  

Czech Sleep Research and Sleep Medicine Society Report Sleep related breathing disorders (SRBD), mainly sleep apnea (SA), strongly caused quality of sleep and subsequently quality of patient’s life. Patophysiologic consequences of SRBD influence course of cardiovascular disorders. Early and quality treatment of SRBD decreased cardiovascular morbidity and mortality and favorably affects their socioeconomic impact. Given mentioned facts the Czech Sleep Research and Sleep Medicine Society (CSRSMS) decided to create guidelines for SRBD treatment using positive airways pressure in adults. SRBD are diagnosed by polysomnography or polygraphy....

Pathophysiology of trunk muscles or cycling as a potential risk factor

MUDr.Tomáš Zeman, Ph.D., prof.MUDr.Zdeněk Novák, CSc., MUDr.Jan Chrastina, Ph.D.

Neurol. praxi. 2013;14(1):42-44  

after surgery for lumbar intervertebral disc herniation? Neurosurgeon is confronted in his daily clinical work with patiens after surgery for lumbar disc herniation asking frequently about the suitability of bicycling for them. The submitted text describes some frequent factors leading to spine problems on the basis of anatomical and pathophysiological aspects, points to the mistakes most frequently encountered in non medical perception of the problem and diagnostic – therapeutic process and points to risk factors. Adequate function of muscular spinal supportive corset should be considered the most importament prevention of spondylogenic...

Orolingual angioedema - complication of acute stroke treatment with systemic thrombolysis

MUDr.Zdeněk Kadaňka ml., MUDr.Stanislav Peška, prof.MUDr.Josef Bednařík, CSc.

Neurol. praxi. 2013;14(1):51-53  

The aim of this study was to investigate the incidence, the severity and possible complications of orolingual angioedema (OA) in patients treated by intravenous trombolysis in the University Hospital, Brno since 2004 till the end of 2011. Patients and methods: This study is the retrospective analysis of 290 patients with acute ischemic stroke treated by recombinant tissue plasminogen activator. The average age was 67 years, 59 % males and 41 % females. All the patients data were sent to the international SITS register. Results: There were three cases of OA (1.03 % of all patients). The anaphylactoid reaction was mild in all cases, with no need...

Chlamydophila pneumoniae and multiple sclerosis

MUDr.Jan Galský, Ph.D., MBA

Neurol. praxi. 2013;14(1):46-50  

Chlamydophila pneumoniae is an intracellular pathogen and important cause of respiratory tract infection. Monocytes may traffic Chlamydophila pneumoniae across the blood-brain-barrier but there is a strong evidence that Chlamydophila pneumoniae has not causal role in multiple sclerosis. Chlamydiae are susceptible to antibiotics that afect DNA and protein synthesis, including macrolides, azalide, specifically azithromycin, tetracyklines, and chinolones. Long-term antibiotic treatment of chronic disaeses, such as multiple sclerosis, Alzheimer´s disease, asthma, atherosclerosis, is unlikely show any benefit. treatment.

Perioral myoclonia with absences: video case reports

MUDr.Irena Doležalová, prof.MUDr.Robert Kuba, Ph.D.

Neurol. praxi. 2013;14(1):54-57  

Perioral myoclonia with absences (PMA) is a syndrome that belongs to the group of idiopathic generalized epilepsies; however, it is not recognized as a separate entity by the current classification. PMA is marked by typical absences and perioral myoclonias characterized by pouting of the lips or twitching of the corners of the mouth, less frequently by rhythmic movements of the lower jaw. PMA is often confused with focal epilepsy, which may have adverse therapeutic consequences. Two case reports of patients with PMA are presented, accompanied by a video recording. The article also deals with the differential diagnosis and treatment of this syndrome.

Nonstandard termination of hospitalization. Legal, medical, and ethical issues

JUDr.Jan Vondráček, JUDr.MUDr.Lubomír Vondráček

Neurol. praxi. 2013;14(1):58  

In their article, the authors address the legal pitfalls of a nonstandard procedure in terminating hospitalization, its legal regulation, and the legality of its use.