Slovo úvodem

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

Neurol. praxi. 2015;16(6)  

Autoimunitní onemocnění centrálního nervového systému

doc. MUDr. Petr Marusič, Ph.D. – editor hlavního tématu

Neurol. praxi. 2015;16(6):316  

Autoimmune encephalitides

MUDr. David Krýsl, Ph.D.

Neurol. praxi. 2015;16(6):317-323  

Autoimmune limbic encephalitides (LE) and encephalitis with antibodies against glutamate NMDA receptors (NMDAR encephalitis) are important subtypes of autoimmune encephalitis. LE are characterised by the presence of subacute-onset memory impairment, epileptic seizures and psychiatric symptoms. Autoantibodies associated with LE may be directed either against intracellular or membrane-bound antigens and the nature of clinical symptoms, findings of supplementary methods, effect of immunotherapy and prognosis are largely determined by the type of associated antibody. NMDAR encephalitis is a diffuse cortical autoimmune encephalitis. It is relatively common,...

Autoimmune syndromes of brainstem and cerebellum

doc. MUDr. Pavel Štourač, Ph.D.

Neurol. praxi. 2015;16(6):324-326  

Autoimmune syndromes of brainstem and cerebellum are usually of paraneoplastic origin. The diagnostics is based on the detection of onconeural antibodies and imaging methods. The early diagnostics enables effective treatment in some cases.

Myelitis

doc. MUDr. Dana Horáková, Ph.D.

Neurol. praxi. 2015;16(6):328-332  

Myelitis represent an etiologically heterogeneous syndrome with acute or subacute onset that is caused by a spinal cord inflammation. In a diagnostic process, it is important to promptly use a combination of imaging techniques (MRI and / or CT) with cerebrospinal fluid examination, while other auxilary tests may be used to elucidate a systemic inflammatory process. It is frequently associated with infectious or autoimmune diseases (multiple sclerosis, neuromyelitis optica, systemic autoimmune disease), but its etiology remains unknown in a substantial portion of cases, which are classified as idiopathic.

Central nervous system vasculitis

MUDr. Aleš Tomek, Ph.D., FESO

Neurol. praxi. 2015;16(6):334-339  

Vasculitides are a very heterogeneous group of diseases with a wide range of clinical presentations. Due to inflammatory changes in the vessel wall, distal tissue is jeopardized by ischaemia (vascular occlusion, embolization) or, less frequently, vessel rupture and bleeding can occur at the site of the injury. Clinically, three basic presentations of CNS vasculitis manifestations can be specified: acute territorial ischaemic stroke, i.e. involvement of large arteries with a typical presentation consistent with the territory affected, but often with accompanying atypical symptoms in the medical history (cephalalgia, encephalopathy, or epileptic seizures);...

When to consider autoimmune etiology of central nervous system disorders in clinical practice

MUDr. Martin Elišák, doc. MUDr. Petr Marusič, Ph.D.

Neurol. praxi. 2015;16(6):340-344  

Autoimmune involvement of CNS can accompany systemic or organ specific autoimmune diseases or is a primary CNS affection. Clinically, autoimmune CNS disorders present with a variety of symptoms and there are distinctive neurological syndromes where autoimmune etiology should be suspected like limbic and NMDAR encephalitis, opsoclonus-myoclonus or stiff person syndrome. In other CNS disorders (myelitis, cerebellar ataxia, acute/subacute encephalopathy, status epilepticus and some types of epilepsy), autoimmune etiology should be considered if no other cause has been identified. Autoimmune etiology can be suggested by results of some investigations –...

Cognitive impairment in multiple sclerosis

MUDr. Zbyšek Pavelek, doc. MUDr. Martin Vališ, Ph.D.

Neurol. praxi. 2015;16(6):347-351  

Multiple sclerosis is a chronic inflammatory disease which is characterized by infiltration of leukocytes into the central nervous system. This situation leads to the destruction of myelin and to the loss of axons and olidendrocytes. Cognitive dysfunction is present in all stages of multiple sclerosis. The impairment of information processing, memory and executive functions are typical findings. The NEDA-4 concept, testing of cognitive dysfunction and treatment are discussed.

Gluten neuropathy

MUDr. Eva Vlčková, Ph.D.

Neurol. praxi. 2015;16(6):352-357  

Gluten-related disorders (GRD) is a term used to describe a spectrum of diseases related to the ingestion of the food containing gluten, a cereal protein contained in wheat, rye and barley. Celiac disease and non-celiac gluten sensitivity are the most prominent clinical units of this group with a high prevalence in general population and variable clinical manifestation in both the cases. Among others, they may present with neurological symptoms, mainly polyneuropathy, which is found in about 50 % of celiac patients. So called gluten neuropathy is usually symmetric chronic, sensory-motor and axonal. Asymetric forms as well as small fiber neuropathy...

Wernicke encephalopathy

MUDr. Michal Vodička

Neurol. praxi. 2015;16(6):360-364  

Wernicke encephalopathy is an acute syndrome resulting from thiamine deficiency. It occurs particularly in alcoholic patients, but also in many other diseases. The typical triad of symptoms of ataxia, ophthalmoplegia and delirium occurs in a minority of patients, so it is necessary to consider this disease even in case of not fully developed symptomatology. The disease is treated with supplementation of thiamine.

De novo development of super-refractory status epilepticus

MUDr. Iva Marečková, MUDr. Zdeněk Vojtěch, MUDr. Tomáš Procházka, MUDr. Denisa Vondráčková

Neurol. praxi. 2015;16(6):366-369  

Cryptogenic new onset refractory status epilepticus (NORSE) syndrome has been described in both adults and children, and is often associated with poor outcome. A variety of terms have been used in the literature to refer to this syndrom. The condition may be triggered by as yet unidentified infections or an immunological mechanism. Early use of immunotherapy appears to be associated with better neurological outcomes.

Back pain in pregnancy as a sign of a life-threatening condition

^*MUDr. Jana Djakow, ^*MUDr. Radka Mišurová, doc. MUDr. Petr Marusič, Ph.D.

Neurol. praxi. 2015;16(6):371-374  

Back pain in pregnancy is a common condition which can be easily trivialized by treating physicians. We present a case series where the back pain was the major or the only clinical sign of a life-threatening condition. We provide an overview of recent knowledge about these conditions from the neurological point of view. We also point out warning signs and a set of examinations that should not be missed out in any pregnant patient with a back pain.