Slovo úvodem

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

Neurol. praxi. 2015;16(5)  

Vertebrogénna problematika – úvod k hlavnej téme

MUDr. Miloslav Dvorák, PhD. – editor hlavnej témy

Neurol. praxi. 2015;16(5):252  

Neuropathic component of back pain

prof. MUDr. Josef Bednařík, CSc.

Neurol. praxi. 2015;16(5):253-256  

Back pain is probably the most prevalent clinical syndrome at all – lifetime prevalence is thought to be approximately >70% and currently about 30% of the population have this condition. Presently, chronic lumbar radicular pain is the most common neuropathic pain syndrome at all. Neuropathic component is present in at least 1/5 patients suffering from back pain. The pathophysiology of back pain is complex. Nociceptive – and neuropathic pain–generating mechanisms are thought to be involved, which established the term mixed pain syndrome. Radicular syndromes serve as typical examples of neuropathic pain. Neuropathic component, however,...

Neurological aspects of lumbar spinal stenosis

doc. MUDr. Blanka Adamová, Ph.D., MUDr. Tereza Andrašinová, MUDr. Roman Kopáčik

Neurol. praxi. 2015;16(5):257-261  

Lumbar spinal stenosis (LSS) is a frequent disease of older age that contributes to impaired mobility of patients, but that is often underdiagnosed. Diagnostics and therapy of patients with LSS are multidisciplinary issue with contribution of neurologist, spine surgeon and radiologist. This article summarizes recent findings about clinical manifestation, diagnostics, differential diagnostics and choice of optimal therapy for patients with LSS.

Algesiologic, neurologic and rehabilitation aspects in diagnostics and therapy of patients

prof. MUDr. Jaroslav Opavský, CSc.

Neurol. praxi. 2015;16(5):262-265  

with chronic nonspecific low back pain Chronic nonspecific low back pain requires a specific approach to its diagnostics and therapy. Somatic and psychic aspects and disability should be assessed in patients with these complaints. Pain and/or algofunctional questionnaires can help in enriching their personal histories. Neurologic examination should involve parts of the algesiologic and kinesiologic examinations, and components of the physical medicine and rehabilitation approach to pain. Attention should be paid to motor control and movement patterns. Rehabilitation in patients with chronic low back pain should include posture-movement education and...

Neurologic complication of diffuse idiopathic skeletal hyperostosis

prof. MUDr. Ivan Rybár, PhD.

Neurol. praxi. 2015;16(5):266-268  

Diffuse idiopathic skeletal hyperostosis is a non-inflammatory degenerative disease affecting the axial skeleton by calcifications and progressive hyperostosis of anterior and posterior longitudinal ligaments. The disease also affects the peripheral insertions on the shoulders, elbows, pelvic region, knees and heels. In coincidence with rheumatoid arthritis is the disease able to ameliorate its destructive outcomes. In addition to the affected bone and ligaments of spine may be present extraosseal findings such as dysphagia, dysphonia and neurological complications. Of these especially pain in the thoracolumbar spine, stiffness and limitation of mobility,...

Osteoporosis and vertebrogenic pain syndrome

MUDr. Daniel Čierny, PhD., MUDr. Kristína Brázdilová, PhD., doc. MUDr. Zdenko Killinger, PhD., prof. MUDr. Juraj Payer, CSc., FRCP

Neurol. praxi. 2015;16(5):269-272  

Vertebrogenic pain syndrome is one of the most common disorders that to a greater or lesser extent affect every human being. It is often the reason for the visit to the clinic of a rheumatologist. The character and the clinical picture vary according to the type of the disease. The authors present a review of the issues with regard to the rheumatologist, focusing on the osteoporosis-related pain, as well as possibilities for diagnostics and differential diagnosis.

New ways of administering injection drugs in relapsing multiple sclerosis

MUDr. Jiří Piťha

Neurol. praxi. 2015;16(5):273-277  

The review article provides information on new ways of administering parenteral drugs indicated in the treatment of multiple sclerosis or clinically isolated syndrome. The issues covered include reducing the frequency of administration and increasing the dose, switching from intravenous or intramuscular to subcutaneous administration, or altering the active molecule. The new drugs have the same efficacy as the original ones, while the rate of adverse effects is maintained or even reduced.

Evaluation of electronic forms for the assessment of spinal cord injured patients

MUDr. Jiří Kříž, Ph.D., MUDr. Renata Háková, Mgr. Zuzana Hlinková, Mgr. Barbora Frgalová, MUDr. Veronika Hyšperská, Mgr. Šárka Špaňhelová

Neurol. praxi. 2015;16(5):280-285  

Detailed neurological and functional examination is fundamental for the evaluation of the development after spinal cord injury. European Multicenter Study about Spinal Cord Injury (EMSCI) has significantly contributed to standardization of processes of investigation. Their widening is going on in the Czech Republic in form of courses on the examination of a spinal cord injured patient organised by the Spinal Cord Unit Prague, University Hospital Motol. Electronic forms could help to simplify processing of obtained information, unify outputs and make the medical documentation better arranged.

Psychogenic nonepileptic seizures

MUDr. Tomáš Nežádal, Ph.D.

Neurol. praxi. 2015;16(5):286-289  

Psychogenic nonepileptic seizures (PNES) are relatively common disease. These patients make up one-fifth of pharmacoresistant seizure patients. There are formed by the mechanism of psychogenic somatoform dissociation in the presence of other factors. In the differential diagnosis, in particular for distinguishing from epileptic seizures, it is video-EEG monitoring and seizure suggestive provocation as a gold standard. Based on repeated observations were identified some typical seizure manifestations. Patients often suffer from other psychiatric comorbidities. The main part of treatment is psychotherapy, however, only a quarter of patients is long-term...

Varicella, herpes zoster, complications and postherpetic neuralgia, prevention

MUDr. Lucie Růžičková Jarešová

Neurol. praxi. 2015;16(5):290-292  

The varicella-zoster virus is the only virus that can cause two different diseases: chickenpox (varicella) and shingles (herpes zoster). Primary infection is characterized by a generalized vesicular eruption on an erythematous base of the skin and the mucosa. Endogenous infection is manifested by a vesicular eruption in a herpetiform pattern along the course of one or more nerve roots, the dermatomes. Primary infection is typical for childhood, causing chickenpox. It most commonly affects children aged three to six years. During the period of primary infection, the virus travels along the sensory nerve from the skin to the appropriate ganglion where...

Pain of mixed etiology in patient with polymorbidity

doc. MUDr. Jiří Kozák, Ph.D.

Neurol. praxi. 2015;16(5):293-295  

Polymorbid patient with pain is a difficult problem for physicians. It is usually more of the diseases that are accompanied by various types of pain, and is treated with medicaments which have different pharmacologic properties and adverse effects (Slíva, 2011). In these cases it is very important detailed examination of pain etiology and rational use of analgesic treatment (Ambler, 2012). In our case report, we present example of polymorbid middle-aged patient who suffers from serious illnesses, underwents radical surgery on the musculoskeletal system and has a long-term chronic medication therapy, including corticosteroids. Patient is treated with...

Fulminant course of lamotrigine-induced toxic epidermal necrolysis

MUDr. Břetislav Lipový, Ph.D., MUDr. Hana Řihová, MUDr. Tomáš Kempný, Ph.D., MUDr. Ivan Suchánek

Neurol. praxi. 2015;16(5):299-301  

Toxic epidermal necrolysis (TEN) is a critical exfoliation syndrome that, due to its local nature, mimics superficial burns. It is a drug-induced reaction that is manifested not only on the skin, but also on the mucosae. The induction of an apoptotic process in the dermo-epidermal junction zone is the underlying cause of the disease. Antiepileptics currently represent one of the most important drug groups with respect to developing TEN. The case report presents a young woman who developed toxic epidermal necrolysis following lamotrigine treatment.

Spontaneous intracranial hypotension: a case report, diagnosis and treatment

MUDr. Zbyšek Pavelek, doc. MUDr. Martin Vališ, Ph.D., MUDr. Ludovit Hofmann Klzo, Ph.D.

Neurol. praxi. 2015;16(5):303-306  

Spontaneous intracranial hypotension is a remarkable but often misdiagnosed cause of new daily persistent headaches. The syndrome is characterised by headache that occurs shortly after assuming an upright position, low cerebrospinal fluid pressure, and magnetic resonance imaging findings diffuse pachymeningeal enhancement after gadolinium administration. We describe a 39-year-old man, with history of an operation of lumbar spine for radiculopathy, who presented 6-weeks after the operation orthostatic headache with photophobia, osmophobia and tinnitus. He was primary diagnose as aseptic meningitis syndrome. Soon after the patient´s history was carefully...