Slovo úvodem

prof. MUDr. Ivan Rektor, CSc.

Neurol. praxi. 2014;15(6):289  

Žena v neurologickej problematike

doc. MUDr. Vladimír Donáth, PhD. – editor hlavního tématu

Neurol. praxi. 2014;15(6):295  

Myasthenia gravis and woman: pregnancy, delivery, postpartum period and transient neonatal myasthenia

doc. MUDr. Peter Špalek, PhD.

Neurol. praxi. 2014;15(6):296-299  

Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction. MG often affects women in the second and third decades of life, overlapping the childbearing years. Women with MG should not be discouraged from conceiving, however, they should discuss their plan for pregnancy with their neurologist and their gynecologist. Generally is accepted that MG females who wish to become pregnant should have their MG under good control, either in remission or in significantly improved and stable condition. MG can be well managed during pregnancy with safe and effective therapies. Anticholinesterase drugs are the mainstay of the treatment. When...

What›s new on the issue of „women and epilepsy”?

MUDr. Jana Zárubová

Neurol. praxi. 2014;15(6):300-304  

Comprehensive clinical approach to women with epilepsy requires consideration of special pathophysiological, diagnostic, therapeutic and social aspects. The aim is to understand and apply this knowledge to allow women with epilepsy live the same life as their peers or with the least possible handicap. Presented update is a sequel of „Woman and epilepsy“ 2nd edition, (EpiStop, 2010), where the topic was delt with in great detail and in multidisciplinary way. Each subtopic of the article includes summary and current data and is accompanied with clinical commentary.

Woman and multiple sclerosis

doc. MUDr. Jarmila Szilasiová, PhD.

Neurol. praxi. 2014;15(6):305-309  

The understanding of the effect of pregnancy and hormonal factors provides a new insight into the mechanisms of multiple sclerosis (MS). MS has no negative effect on fertility, course of pregnancy, or fetal health. During pregnancy, the majority of women experience a decrease in disease activity, with a higher risk of relapse in the first three to six months after childbirth. The results of studies on the effect of MS treatment on the course of pregnancy and child development are inconsistent. Pharmacological treatment of MS with a potential teratogenic effect should be discontinued prior to pregnancy. Treatment in the postpartum period depends on...

Specifics of cerebrovascular diseases in women

MUDr. Norbert Leško, MUDr. Matej Škorvánek, MUDr. Vladimír Haň

Neurol. praxi. 2014;15(6):310-313  

Stroke is currently a serious problem concerning health, social and economic issues. Although the risk of stroke for certain age groups is higher in men than in women, female’s contribution to the overall stroke count is greater because of their relative long evity combined with a higher incidence of stroke in the highest age groups. Increased prevalence of certain risk factors, such as arterial hypertension, atrial fibrillation and worse functional disability at the onset of stroke was identified in female cohorts. Women with acute stroke are less likely to receive systemic thrombolytic therapy compared to men. After the stroke women achieve...

Migraine in women

MUDr. Zuzana Dean, MRCP

Neurol. praxi. 2014;15(6):314-318  

Migraine is a predominantly female disorder. Menarche, menstruation, pregnancy, and menopause, and also the use of hormonal contraceptives and hormone replacement treatment may influence migraine occurrence. Migraine usually starts after menarche, occurs more frequently in the days just before or during menstruation, and ameliorates during pregnancy and menopause. Those variations are mediated by fluctuation of estrogen levels through their influence on cellular excitability. Moreover, administration of exogenous hormones may cause worsening of migraine and may expose migrainous women to an increased risk of vascular disease. Migraine with aura represents...

The individual preferences in choice of suitable MS treatment therapy

MUDr. Marta Vachová

Neurol. praxi. 2014;15(6):319-323  

The decision of the type of treatment according actual health condition and personal issue of the patient is crutial for multiple sclerosis therapy. Right choice is important for adherence and effectiveness of that. We talk about personalized medicine. The basic therapeutic recommendations are based on the dates from classical clinical studies and statistically defined effectivity of the therapy. The individual strategy is necessity for maximum of the effectiveness.

Early cerebrovascular complications after cardiovascular surgeries

MUDr. Jan Chrastina, Ph.D., prof. MUDr. Zdeněk Novák, CSc., MUDr. Jaroslav Brichta, MUDr. Petr Pavlík, ing. Ivo Říha, doc. MUDr. Petr Němec, CSc.

Neurol. praxi. 2014;15(6):324-328  

Intracerebral haematoma and brain ischaemia are exceptional, but very serious complications occuring in patients after heart surgeries. The incidence of such complication is determined by many factors depending on the general condition of the patient and the type of heart surgery. When discussing surgical indication not only the general neurosurgical indication criteria valid for patients with intracerebral haematoma or expansive brain ischaemia, but the general condition of the patient after heart surgery with potential circulatory instability, anticoagulation treatment and the need for vital function support.

Presented article deals with swallowing problems in patients with Parkinson’s disease

Mgr. Marie Kaniová, Ph.D., MUDr. Pavel Ressner, Ph.D., Mgr. Barbora Kopecká, MUDr .Karol Zeleník, Ph.D.

Neurol. praxi. 2014;15(6):329-332  

Dysphagia is very common symptom in patients with Parkinson’s disease, often resulting in poor quality of life – as an result of decreased food intake, malnutrition and bronchopneumonia. Dysphagia is overall pretty good curable disorder and it is necessary to keep it in mind, because it is often overlooked during neurological examination of a patient with Parkinson‘s disease. The article summarizes basic terminology related to dysphagia and describes physiological course of the swallowing act. The possibilities of instrumental examination of swallowing problems and other investigative techniques are shortly described. Problems with...

Fingolimod in clinical practice: case reports

doc. MUDr. Radomír Taláb, CSc., MUDr. Marika Talábová

Neurol. praxi. 2014;15(6):333-337  

Treatment escalation in multiple sclerosis (MS) can be achieved by the use of fingolimod that represents an advancement in treating MS not only due to its mechanism of action, but also because of its dosage form (tablets). Fingolimod was the first oral medication for the treatment of relapsing-remitting MS (RRMS). It is the first sphingosine-1-phosphate (S1P) receptor modulator. Fingolimod binds to the S1P receptor on lymphocytes and, by reducing its expression, prevents lymphocytes from exiting lymphatic tissue. This mechanism inhibits the migration of autoreactive lymphocytes into the CNS and the development of inflammatory changes. Fingolimod crosses...

Treating late stage Parkinson's disease with continuous Duodopa administration

MUDr. Václav Dostál, doc. MUDr. Edvard Ehler, CSc., MUDr. Petr Vyhnálek, Ph.D.

Neurol. praxi. 2014;15(6):338-340  

We report a case of a 63-year-old patient in late stage Parkinson's disease in whom compensation of late motor complications could no longer be achieved with oral treatment. Following the insertion of a PEG tube and intrajejunal administration of the Duodopa gel, the patient's condition improved significantly, with substantial regression of the 'off' states and alleviation of hyperkinesia.

Pompe disease - clinical case report

MUDr. Ing. Ivana Patáková, CSc.

Neurol. praxi. 2014;15(6):341-345  

Glycogen storage disease II type (GSD II, m. Pompe) is an autosomal recessive disorder with an incidence of about 1: 60 000. It is caused by a deficiency of lysosomal hydrolytic enzyme acid maltase (alpha-glucosidase), which is responsible for degradation of intralysosomal glycogen. The structural gene for alpha-glucosidase was localized on chromosome 17q23. According to the clinical manifestations and age of the first symptoms manifestation there are two main types of the disease. The infantile form of GSD II affects children in the first months of life. They are significantly hypotonic (” floppy baby”), respiratory muscles are also affected...

Pure akinesia with gait freezing

MUDr. Ján Necpál

Neurol. praxi. 2014;15(6):346-349  

This article describes a relative „young“ and rare diagnosis on the field of movement disorders, known as pure akinesia or pure kinesia with gait freezing. The cardinal clinical feauture of the syndrome is akinesia and levodopa-resistant progressive freezing during walking, speaking and handwriting. Limb rigidity, oculoparesis and dementia are not present. Pathologically this syndrome shows changes typical for progressive supranuclear palsy, therefore pure akinesia is regarded as its clinical variant. The article presents a short clinical case of a patient reflecting a graduate conversion of seven years existing pure akinesia to the typical...

Pharmacological profile of pregabaline (Lyrica)

doc. MUDr. Edvard Ehler, CSc.

Neurol. praxi. 2014;15(6):350-354  

Pregabaline (Lyrica) is a derivative of gamma-amino-butyric acid. It acts on a subunite of a voltage-gated calcium channel, and in this way it modulates an input of calcium into neurons of the central nervous system. Pregabaline is characterized by anticonvulsive, anxiolytic and analgesic effects. Pregabaline does not bind to plasmatic proteins and nearly unchanged is excreted into urine. An advantage of pregabaline is a linearly increasing effect during increasing dosage of drug. The main indication of pregabaline is neuropathic pain. The next indications are partial epileptic seizures, generalized anxiety disorder, lower back pain associated with...