Slovo úvodem

prof. MUDr. Ivan Rektor, CSc., FCMA, FANA

Neurol. praxi. 2014;15(4):171  

Poruchy chování související se spánkem

prof. MUDr. Karel Šonka, DrSc.

Neurol. praxi. 2014;15(4):177  

Sleep and epilepsy

MUDr. Zdeněk Vojtěch, Ph.D.

Neurol. praxi. 2014;15(4):178-181  

In some epileptic syndromes, epileptic seizures may be caused by pathological activation of neuronal networks which in normal cicumstances regulate sleep and wake cycle. It applies to perisylvian network in LKS and ESES, thalamo-cortical in IGE, frontal in NFLE, and temporolimbic in TLE. In some epileptic syndromes this may interfere with mechanisms for which sleep is important and cause cognitive defect. Sleep disorders and epilepsy frequently coexist and treatment of one condition may have positive impact on the other.

Sleep disturbances and sundowning in Alzheimer’s disease and other dementias

doc. MUDr. Robert Rusina, Ph.D., doc. MUDr. Iva Holmerová, Ph.D.

Neurol. praxi. 2014;15(4):182-185  

Sleep disturbances and sleep cycle distorsions are relatively common complications of dementia with a negative impact on both the patient’s and his caregiver’s state. Often their occurrence contributes to early institutionalization and may complicate provided care in nursing homes. Sleep disturbances in various neurodegenerative disorders, sleep cycle distorsions and sundowning and their impact on caregivers are discussed. The management is complex, based on non-pharmacological interventions and targeted pharmacotherapy.

NREM arousal parasomnias

MUDr. Jitka Bušková

Neurol. praxi. 2014;15(4):186-188  

NREM arousal parasomnias include confusional arousals, sleepwalking (somnambulism) and sleep terrors (pavor nocturnus). These parasomnias occur primarily in childhood and in 2–4 % of adults. Factros that deepen sleep and factors that fragment sleep have been reported as facilitating or triggering episodes in predisposed individuals. Polysomnography and video-EEG monitoring is indicated in clinically ambiguous cases. A variety of pharmacological as well as non-pharmacological treatments have been recommended for long- -term management of NREM parasomnias.

REM sleep behaviour disorder - a nosological entity with a great significance for neurology

prof. MUDr. Karel Šonka, DrSc.

Neurol. praxi. 2014;15(4):189-191  

The article briefly discusses the main manifestations of REM sleep behaviour disorder (RBD), its new 2014 diagnostic criteria, and some pitfalls of diagnosing. The association of RBD with synucleinopathies is dealt with in more detail and facts are presented showing that, in many cases, RBD is one of the first signs of the development of a neurodegenerative disease. The article also mentions other aspects of developing RBD, particularly the use of antidepressants.

Dimethyl-fumarate in treating relapsing-remitting multiple sclerosis

MUDr. Eva Meluzínová

Neurol. praxi. 2014;15(4):192-196  

Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system (CNS), with neurodegeneration occurring from the very onset of the disease. With timely treatment, it is possible to slow down the whole immunopathological process. Therefore, treatment is best initiated at the first sign of disease or in the stage of relapsing-remitting MS (RRMS). In such a case, first-choice drugs are used (disease-modifying drugs – DMD). Escalation is required in patients with an insufficient effect of this treatment. For this purpose, either intravenous natalizumab or oral fingolimod are available. So far, none of...

Multiple sclerosis and pregnancy

MUDr. Olga Zapletalová

Neurol. praxi. 2014;15(4):197-201  

Multiple sclerosis is an autoimmune inflammatory and neurodegenerative disease affecting young women of childbearing age. Owing to the knowledges and modern therapeutic approaches the illness can be really stable and women can carry out their biological role and have children. Maternal immune system undergoes profound transformations at the very beginning of pregnancy. The major changes are directed to protect the fetus from a detrimental immune response and the growing level of pregnancy hormones affects the mother´s immune reactions. According to the results of the clinical trials and long-term clinical experience the pregnancy has positive effect...

Ideopathic generalized epilepsies

MUDr. Štefánia Aulická, doc. MUDr. Hana Ošlejšková, Ph.D.

Neurol. praxi. 2014;15(4):202-206  

Idiopathic generalized epilepsies (IGEs) constitute one-third of all epilepsies. They are genetically determinate in some epileptic syndromes the molecular-genetic etiopatogenesis is known. Clinical status is performed by age of onset of disorder, type of seizures (typical absences, myoclonic jerks, generalized tonic clonic seizures alone or in varying combinations) and characteristic EEG features. The article provides review of individual epileptic syndromes, their clinical status, diagnostic, therapy and prognosis with information about actually known molecular-genetic base of IGEs. Dividing of epileptic syndromes result from Proposal ILAE Task Force...

The incidence, prevention and treatment of decrease BMD and fractures in patients with Duchenne muscular dystrophy

MUDr. Ondřej Souček, Ph.D.

Neurol. praxi. 2014;15(4):207-209  

Osteoporosis and increased fracture rate are serious and frequent complications in patients with DMD. Despite prolonged ambulation with corticosteroid treatment, its use is considered, in addition to muscular weakness, a risk factor for osteoporosis in DMD patients. BMD, as assessed by DXA, is a useful tool for monitoring bone health. BMD result should be always adjusted to patient’s height. Vertebral compressions need to be verified by lateral radiographs of the spine. Prolonged ambulation, alternate corticosteroid use, securing normal serum calcium and vitamin D levels are among the preventive measures to reduce the osteoporosis risk. Bisphosphonates...

Duodopa in advanced Parkinson's disease in clinical practice - a case report

doc. MUDr. Martin Vališ, Ph.D.

Neurol. praxi. 2014;15(4):210-212  

The case report describes a 63-year-old man with advanced Parkinson's disease at the stage of late motor and mental complications in whom, following the failure of classic pharmacotherapy, treatment with Duodopa was used in a long-term and safe manner.

Late manifestation of Pompe disease

MUDr. Tomáš Kalous

Neurol. praxi. 2014;15(4):213-215  

Pompe disease is an autosomal recessive hereditary storage disease caused by mutations in the gene for acid maltase leading to a varying degree of its deficiency, which causes accumulation of glycogen in all organs, especially in striated muscles and in newborns even in the myocardium. It is divided into two basic forms – the infantile and adult. In this article is presented a case report of adult-onset disease with the development of symptoms at the end of the 6th decade of age manifested gradually and progresses to asymmetric girdle weakness of the lower limbs. Due to very low occurrence of the disease and the absence of specific symptoms,...

Churg-Strauss syndrome with a central neurological finding

MUDr. Jiří Piťha, MUDr. Marta Vachová, MUDr. Jana Kotalová, MUDr. Simona Vondráčková, MUDr. Markéta Ceé

Neurol. praxi. 2014;15(4):216-218  

We report a case of a young female patient who presented with a monophasic multifocal neurological finding. The correct diagnosis was only determined based on differential diagnosis of multiple sclerosis. The subsequent course and clinical finding were indicative of Churg-Strauss syndrome, with four diagnostic criteria (bronchial asthma, nasal polyps, eosinophilia, and neurological symptomatology) being met. A dominant central neurological finding was unusual.

Cyclic vomiting in adulthood

MUDr. Ivan Buran, CSc.

Neurol. praxi. 2014;15(4):220-221  

A case report is presented of cyclic vomiting in adulthood when this clinical entity is rare and can be mistaken for a disease of the gastrointestinal tract. It is characterized by intervals of profound, disabling difficulties followed by periods of time with no or only mild problems, with exclusion of processes of the gastrointestinal tract and structural processes of the central nervous system. Manifestations of cyclic vomiting are reported in an adult individual who had been followed for gastrointestinal complaints, with a possibility of psychogenic changes, for six years. Antimigraine treatment was partially successful.

doc. MUDr. Otakar Keller, CSc. (1945-2014)

Jolana Marková, Robert Rusina

Neurol. praxi. 2014;15(4):222