Slovo úvodem

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

Neurol. praxi. 2015;16(1)  

Úvod k hlavnímu tématu spasticita

prof. MUDr. Martin Bareš, Ph.D.

Neurol. praxi. 2015;16(1):9  

Pathophysiology of spasticity

prof. MUDr. Petr Kaňovský, CSc.

Neurol. praxi. 2015;16(1):10-13  

Spasticity is defined as impaired muscle tone (hypertonia) caused by an increase in tonic stretch reflexes that is dependent on the speed of passive muscle stretching, and this increase in tonic stretch reflexes is likely to directly result from abnormal processing and modulation of proprioceptive impulses conducted by class Ia and Ib proprioceptive fibres, in the eloquent cortex in the brain. In the clinical setting, spasticity is a part of upper motor neuron syndrome, being one of the so-called positive signs. It is accompanied by other phenomena that are a manifestation of abnormal excitatory as well as inhibitory supraspinal descending drive: flexor...

Clinical aspects of spasticity

prof. MUDr. Robert Jech, Ph.D.

Neurol. praxi. 2015;16(1):14-19  

Paresis is one of the three main clinical symptoms of the upper motor neuron lesion. Other symptoms, which could worsen central palsy, are muscle shortening and increased muscle activity. Besides motor inactivity, muscle shortening is caused by the atrophy of the muscle, tendon and surrounding soft tissues and is accompanied by decreased contractility, elasticity and loss of muscle volume, all of which leads to a fixed contracture in later stages. Increased muscle activity emerges a couple of weeks or months after the central lesion and is responsible for further deterioration of the paresis. It manifests with spasticity – a sudden increase in...

Spasticity - clinical scales

doc. MUDr. Edvard Ehler, CSc.

Neurol. praxi. 2015;16(1):20-23  

Central motoneuron lesion is manifested by negative and positive signs, that lead to an increased muscle tone and to an increased muscle acitivity. On the development of clinical picture of spastic paresis there are participating as fibroelastic muscle components just as increased muscle activity - stretch sensitive spasticity, spastic dystonia, co-contraction, flexion and extension spasms. For desciption of spastic paresis there are used various scales, that inable substantially more detailed evaluation of clinical finding and long-term monitoring.

Treatment of spasticity

MUDr. František Cibulčík, PhD.

Neurol. praxi. 2015;16(1):24-29  

Spasticity is a serious manifestation of central nervous system disease causing significant deterioration in the quality of life of the patient. It is encountered in aetiologically diverse types of brain and/or spinal cord injury – most commonly stroke, poliomyelitis, multiple sclerosis, and nervous system trauma. Treatment of spasticity is characteristic for its comprehensive nature taking into account the specific aetiology as well as the extent and duration of nervous system injury. It consists of a combination of three groups of therapeutic strategies: rehabilitation, pharmacological, and surgical treatment. The paper presents an overview...

Patophysiology of motor adverse event of long term treatment of Parkinson’s disease with dopaminergic medication

MUDr. Branislav Veselý, MUDr. Gabriel Hajaš, PhD., doc. MUDr. Miroslav Brozman, CSc., prof. MUDr. Ivan Rektor, CSc., FCMA, FANA

Neurol. praxi. 2015;16(1):30-32  

Treatment of Parkinson’s disease with dopaminergic preparation has besides the positive effects on the course of the disease many side effects. The most prominent adverse event of long term administration of levodopa and dopamine receptor agonist are motor fluctuation, levodopa induced dyskinesias and psychotic side effects. Authors in the article describe the patophysiology of motor fluctuation and levodopa induced dyskinesias in the patients with Parkinson’s disease treated by dopaminergic medication.

Lumbar spinal stenosis - surgery or conservative treatment?

MUDr. Blanka Adamová, Ph.D., MUDr. Stanislav Voháňka, CSc.

Neurol. praxi. 2015;16(1):34-37  

Lumbar spinal stenosis (LSS) is considered a slowly progressive disease with long-term clinical stability. However, its natural course remains largely unknown. Two therapeutic options present themselves – conservative treatment or surgical treatment. At the current time, there is no general agreement about approaches to LSS therapy. This article summarizes the pros and cons the two therapeutic methods and presents certain outcome predictors; the authors also draw up recommendations that may assist choice of optimal therapy for patients with LSS.

Dravet syndrome: severe myoclonic epilepsy in infancy.

MUDr. Pavlína Danhofer, MUDr. Ondřej Horák, RNDr. Lenka Fajkusová, CSc., Mgr. Jana Pavloušková, doc. MUDr. Hana Ošlejšková, Ph.D.

Neurol. praxi. 2015;16(1):38-42  

Dravet syndrome is classified as a rare progressive epileptic encephalopathy. Seizure onset starts in the first year of life in so far normal developped children. Generalised or lateralized clonic-tonic seizures, often prolonged and during the febrile infect can be observed. Later on, we can see other types of seizures accompanied by deterioration of psychomotor development. In present, the genetic basis of this syndrom with mutations in SCN1A gene can be detected in 70–80 % of patients. 5 % of patients have mutation in PCDH19 gene, rarely the mutations in GABARG2 and SCN1B genes can be detected. Beneficial effect in the therapy of DS is observed...

Effect of LPG-endermotherapy on skin changes resulting from long-term treatment with glatiramer acetate

MUDr. Jana Földesová, MUDr. Vladimír Drvota, MUDr. Eva Meluzínová

Neurol. praxi. 2015;16(1):44-47  

Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system (CNS). Early initiation of treatment can slow down the whole process. The article deals with local adverse effects at the injection site when using glatiramer acetate (GA) – Copaxone®, and, in particular, with interfering with the local response by means of the LPG-endermotherapy technique. It is a unique technology that was developed based on personal experience of the founder and author, Mr. Louis Paul Guitay (LPG). Endermotherapy is mechanical stimulation of sensitive tissue with a special lift head during which activation of fibroblasts and stimulation...

Pompe disease - case report of the juvenile form

MUDr. Katarína Okáľová, PhD., Mgr. Slavomíra Mattošová, doc. MUDr. Ján Chandoga CSc., MUDr. Viera Holecová

Neurol. praxi. 2015;16(1):48-50  

Pompe disease is a rare inherited disease that is caused by a deficiency of the enzyme alpha-glucosidase, which is located in the lysosomes and isused to break down glycogen. This disease belongs to the group of lysosomal storage diseases. Excessive glycogen accumulates in the lysosomes in every cell of the body, most affected being skeletal and cardiac muscle. Clinical symptoms can vary widely according to the residual enzyme activity, infantile variants are dominated by the involvement of the heart muscle and juvenile and adult variants are dominated by skeletal muscle disease. In laboratory tests, the majority of patients display elevated levels...

Treatment of advanced stage Parkinson's disease with intraduodenal levodopa infusions

MUDr. Michaela Kaiserová, MUDr. Martin Nevrlý, Ph.D., Renata Coufalová, prof. MUDr. Petr Kaňovský, CSc.

Neurol. praxi. 2015;16(1):51-53  

L-DOPA is still considered to be the most effective drug in treating Parkinson's disease. However, its long-term administration is associated with the development of late motor complications that are thought to be due to non-physiological intermittent administration of L-DOPA. Elimination of pulsatile stimulation of dopamine receptors by adjusting a more stable concentration of dopaminergic agents in the plasma and in the striatal region can consequently lead to a significant reduction in these motor complications. We present a case report of a patient with advanced stage Parkinson's disease in whom the introduction of continuous intestinal L-DOPA...

Reaction time proper. Unilateral tumour of the frontal lobe-does it affect the reaction time?

prof. MUDr. Lubor Stejskal, DrSc., MUDr. Svatopluk Ostrý, Ph.D., MUDr. RNDr. Ondřej Bradáč

Neurol. praxi. 2015;16(1):54-57  

In 51 patients with unilateral involvement of the anterior frontal cortex, the reaction time of hand movement to a somesthetic stimulus was assessed. The actual reaction time (the reaction time left after subtracting the time taken for a stimulus to reach the brain and the time of brain output to muscle) is independent of the site, size, and tissue composition of a frontal lobe tumour of the cerebrum. Extensive gliomas of the dorsolateral prefrontal cortex and those of the orbitofrontal cortex, large convexity meningiomas, and parasagittal meningiomas failed to cause a significant disturbance in the reaction time. The actual reaction time in unilateral...

Neurologové se ptají...

prof. MUDr. Irena Rektorová, Ph.D.

Neurol. praxi. 2015;16(1):58