Slovo úvodem

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

Neurol. praxi. 2015;16(4)  

Sportovní neurologie

prof. MUDr. Petr Kaňovský, CSc., prof. MUDr. Egon Kurča, PhD.

Neurol. praxi. 2015;16(4):184  

Back pain issues in cyclists

MUDr. Pavel Otruba, MBA

Neurol. praxi. 2015;16(4):185-187  

Riding a bicycle is the most popular and very widespread sports activity that leads to improved physical and mental performance. However, improper choice of a bicycle, incorrect posture and riding technique can result in deterioration of physical condition, particularly manifested by pain in the neck or lower back. The article highlights the most common health issues associated with riding a bicycle and the options of managing them in order to better enjoy bicycle riding.

Neurological features of decompression sickness in recreational divers

prof. MUDr. František Novomeský, PhD., MUDr. Štefan Sivák, PhD., MUDr. Martin Janík, PhD., prof. MUDr. Egon Kurča, PhD.

Neurol. praxi. 2015;16(4):188-192  

Authors of the paper focused on etiology and pathogenesis of neurologic form of decompression sickness in recreational divers, and its clinical symptomatology as well. Simultaneously, three case reports are presented, which were medically analysed by the first author of the paper, the state expert on hyperbaric and diving medicine.

Acute mountain sickness

prof. MUDr. Egon Kurča, PhD., MUDr. Štefan Sivák, PhD., MUDr. Vladimír Nosáľ, PhD., prof. MUDr. František Novomeský, PhD.

Neurol. praxi. 2015;16(4):193-195  

Acute mountain sickness (AMS) is a syndrome or a continuum of medical conditions ranging from mild headache to a polysymptomatic life-threatening condition with an underlying combination of cerebral oedema with pulmonary oedema. The common feature of these diagnoses is exceeding the altitude and performance capacity in a particular person during a rapid ascent to high mountain grounds without adequate acclimatization. The review article deals with the clinical presentation of AMS, the pathophysiology, and options of effectively preventing its development or subsequent therapeutic procedures required.

Neuro(physio)logy of golf

prof. MUDr. Ing. Petr Hluštík, Ph.D.

Neurol. praxi. 2015;16(4):196-199  

Golf is a specific sport, involving brief physical acts combining strength and precision interleaved with much longer pauses suitable for reflection and planning. Modern functional imaging and neurophysiological techniques have generated interesting information on brain and autonomic nervous system activity during top expert performance in this sport. Elite performance of professionals is supported by specific dynamic balance in participation of motor and non-motor structures of the brain. Whereas neurophysiological research provides leads to increased golf performance, the sport itself may, on the other hand, offer a motivating medium for rehabilitation...

Comments to walk and run in ambulance clinical neurologist

doc. MUDr. Alois Krobot, Ph.D.

Neurol. praxi. 2015;16(4):200-204  

Human walking and running are rightly considered to represent an optimal physical activity for almost everyone. We recapitulate the principal kinesiology and neurophysiological findings about human locomotion. Futhermore this is present with respect to underestanding of painful movement disorders particularly as the result of functional physical discoordination during both prolonged fast walking and recreational running. We suggest selected diagnostic and therapeutic bases useful for the clinical neurologist.

Peripheral nerve injury during sports

MUDr. František Cibulčík, PhD.

Neurol. praxi. 2015;16(4):205-208  

Peripheral nerve injuries comprise an important group of sports-related traumatic injuries. Their early recognition and determination of correct treatment can be crucial in terms of the athlete's further professional career. They are often mistaken for orthopaedic and vascular traumatic events, which results in prolonged recovery. Our paper introduces the most common forms of sports-related peripheral nerve injuries and describes the mechanism of origin, association with particular sports, and clinical presentation.

Treatment of movement impairment in Huntington΄s disease

MUDr. Jiří Klempíř, Ph.D., prof. MUDr. Jan Roth, CSc.

Neurol. praxi. 2015;16(4):209-214  

Huntington´s disease (HD) is the autosomal dominantly inherited progressive neurodegenerative disease. The clinical picture of HD is characterized by motor symptoms, behavioral changes and cognitive decline. The medication of HD is purely symptomatic, no causative or disease-modifying therapies are available. The degree of choreatic dyskinesias can be ameliorated by antagonists of postsynaptic dopamine receptors – antipsychotics (tiapride, risperidone, haloperidol etc.) or depletors of dopamine (tetrabenazine). Dystonic posturing could be improved by amantadine. In rare juvenile cases with dominant rigidity and akinesia amantadine or levodopa...

Chronic inflammatory demyelinating polyradiculoneuropathy

doc. MUDr. Edvard Ehler, CSc.

Neurol. praxi. 2015;16(4):215-218  

Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is characterized by relapsing or progredient course. This is an autoimmune polyradiculoneuropahty with activation of cellular and humoral mechanisms and with primary lesion of myelin sheath in peripheral nerves. Demyelinating and remyelinating changes could be disclosed by nerve biopsy, or their equivalent proved with help of neurophysiological investigation. In clinical finding there is motor nerve disorder in distal and also proximal regions, in typical form in all four extremities, disturbances of sensitive and autonomic nerves are present. Besides the most frequent typical form there...

Treatment with interferon beta despite persistent elevation of liver enzymes

MUDr. Magdaléna Hladíková, Ph.D., MUDr. Petra Praksová, Ph.D., MUDr. Hana Dujsíková, Ph.D.

Neurol. praxi. 2015;16(4):219-221  

Interferon beta 1b (Betaferon) has been the longest used disease-modifying drug in multiple sclerosis. Its side effects include, among other things, elevated liver aminotransferases, which reflects hepatocellular injury. It is, however, unclear what exact changes in the liver parenchyma occur. Data are available only from liver biopsies of patients with fulminant hepatic failure, resulting from another underlying cause. Our case report presents a patient treated with Betaferon since 1999 who had developed elevation of liver enzymes with a gradual increase as early as the first year of treatment and, transiently, third-degree toxicity was reached. Given...

Drug induced hepatopathy after fingolimod treatment

MUDr. Petra Praksová, Ph.D., MUDr. Magdaléna Hladíková, Ph.D.

Neurol. praxi. 2015;16(4):223-226  

We report a case of 34-year-old man with multiple sclerosis with recurrent hepatopathy of toxicity grade 3 after Gilenya treatment in the first 6 months of our treatment. We must twice discontinue treatment with Gilenya due to hepatopathy. There was no episode of recurrent hepatopathy in the next 1,5 year. Our patient is clinically and radiologically stabilized.

Deliberation about diagnostic overlaps of pregabalin treatment

MUDr. Pavel Dohnal

Neurol. praxi. 2015;16(4):227-230  

Pregabalin(PGB) is a medical substance usefull in more situations. Initialy was used as anticolvulsant medication, but it is used in therapy of neuropatic pain too. Neuropatic pain unlike to somatic pain arises due to gained hypersensibility and hyperexcitability of neurons. PGB increases main inhibitor GABA and decreases quantity of excitate neurotransmitters, which cause decreasing of interneuronal communication. At Generalised anxiety disorder (GAD) is used this effectiveness similarly, where also exhibitions of excessive interneuronal communication is common. PGB in sleeptime increases quantity of NREM3 and simultaneously decreses REM a NREM1,...

Glatiramer acetate and treatment of multiple sclerosis

doc. MUDr. Radomír Taláb, CSc., MUDr. Marika Talábová, MUDr. Ludovít Hofmann Klzo, Ph.D.

Neurol. praxi. 2015;16(4):231-235  

The 2010 revised McDonald criteria reflect the clinical requirement to establish the diagnosis of multiple sclerosis (MS) as early as the initial attack of neurological symptoms, in an early stage – that of clinically isolated syndrome (CIS). CIS is the indication for a diagnostic triad of paraclinical investigations that can support the hypothesis of the initial demyelinating attack of MS and predict the likelihood of conversion to clinically definite MS – CDMS. Early diagnosis is required to meet the need for early MS treatment. Treatment with glatiramer acetate (GA) or other medicinal products for the first-line treatment of MS (interferon-beta...

Komentář k článku „Právně-etická problematika pitev a výzkumu z tkání získaných post mortem”

MUDr. Zdeněk Rohan, doc. MUDr. Radoslav Matěj, Ph.D.

Neurol. praxi. 2015;16(4):242  

Alemtuzumab in multiple sclerosis treatment

MUDr. Eva Meluzínová

Neurol. praxi. 2015;16(4):237-240  

Alemtuzumab (Lemtrada®) is a humanized monoclonal antibody indicated for the treatment of highly active relapsing-remitting multiple sclerosis (RRMS).Alemtuzumab causes cytolysis of circulating B and T lymphocytes by binding to their surface marker, CD52. The newly achieved repopulation of lymphocytes subsequently leads to a rebalancing of the immune system. In clinical trials with active comparator (IFN-beta-1a -Rebif 44) demonstrated alemtuzumab superior efficacy when evaluating the annualized relapse rate, progression of disability, the number of new or enlarging lesions on magnetic resonance imaging (MRI) and increasing brain atrophy. Data...