Neurology for Practice, 2016, issue 5

Editorial

Slovo úvodem

prof. MUDr. Ivan Rektor, CSc.

Neurol. praxi. 2016;17(5):276

Main topic

Aspekty současné neuroonkologie

doc. MUDr. Radim Jančálek, Ph.D. – editor hlavního tématu

Neurol. praxi. 2016;17(5):280-281 | DOI: 10.36290/neu.2016.058

Proton MR spectroscopy in neurooncology

MUDr. Martin Bulik, MUDr. Tomáš Kazda, doc. MUDr. Radim Jančálek, Ph.D.

Neurol. praxi. 2016;17(5):283-286 | DOI: 10.36290/neu.2016.059

Proton MR spectroscopy provides the non-invasive assessment of metabolites in examined tissue, can be used to get intracranial neoplasms structural information, increases the specificity of structural magnetic resonance and may serve as an additional examination for evaluation of the response to treatment and decisions to change the treatment strategy as it is in diferentiation of posttreatment changes and recurrence after comlex oncologic treatment of glioma patients. Biochemic changes in glioma differ according to histology and tumor grading. The results of MR spectroscopy can be used for several indications in neurooncology. However, it is important...

Current strategy for treatment of high-grade gliomas

MUDr. Petr Pospíšil, MUDr. Tomáš Kazda, prof. MUDr. Pavel Šlampa, CSc., doc. MUDr. Radim Jančálek, Ph.D.

Neurol. praxi. 2016;17(5):287-292 | DOI: 10.36290/neu.2016.060

In recent decades, there have been significant advances in the standard therapy of high-grade gliomas. New surgical procedures were introduced; radiotherapy methods were improved. It was also found that the use of chemotherapy in specific tumor types further improves the treatment effects. Diagnostic procedures developed as well. However, treatment results are still not satisfactory. The survival of patients with glioblastoma improved only by a few months in the last several decades. The mainstay of malignant gliomas treatment is always maximal safe tumor resection as feasible without functional consequences. Additional treatment depends on histology...

Radiotherapy in brain metastases treatment

MUDr. Ludmila Hynková, prof. MUDr. Pavel Šlampa, CSc., doc. MUDr. Radim Jančálek, Ph.D.

Neurol. praxi. 2016;17(5):293-297 | DOI: 10.36290/neu.2016.061

Brain metastases are ten times more common than primary brain tumors. Patients with brain metastases represent a large group indicated to radiation treatment. This article summarizes the most commonly used radiotherapy techniques, as well as side effects and the ways of their treatment.

Review articles

Safety aspects of treating relapsing-remitting multiple sclerosis

MUDr. Radek Ampapa, MUDr. Stanislav Kopecký

Neurol. praxi. 2016;17(5):300-304 | DOI: 10.36290/neu.2016.062

Multiple sclerosis a serious disease of the central nervous system in which an autoimmune inflammatory process is directed against the myelin sheaths of nerve fibres. In addition to inflammatory mechanisms, neurodegenerative processes are also involved. The treatment options for multiple sclerosis have been expanding considerably in the recent years and more novel drugs are expected to be available for use in the clinical practice within the next two years. This progress results not only in higher treatment efficacy, but also a wider spectrum of adverse effects. For this reason, careful monitoring of adverse effects, collaboration with other medical...

Alzheimer’s disease as a neuropathological continuum in clinical practice.

MUDr. Kateřina Sheardová, MUDr. Daniel Hudeček, MUDr. Olga Hromková, Ph.D., Rafal Marciniak, prof. MUDr. Jakub Hort, Ph.D.

Neurol. praxi. 2016;17(5):305-309 | DOI: 10.36290/neu.2016.063

How did we improve the diagnosis since 1984 and why we don’t have a causal therapy yet? In 2011, new guidelines for the diagnosis of Alzheimer’s disease (AD) based on biomarker assessment were published. They define AD as a neuropathological continuum independently of the clinical symptoms of the patient. They describe three clinical stages – preclinical with AD pathology only, prodromal with AD pathology and mild cognitive impairment and dementia stage. We evaluate the benefits and pitfalls of particular biomarker examinations, their availability and benefits for clinical practice and the ethical impact of early diagnosis in the...

From the boundary of neurology

Immunological outlook on modern therapy of multiple sclerosis

doc. MUDr. Vojtěch Thon, Ph.D.

Neurol. praxi. 2016;17(5):310-314 | DOI: 10.36290/neu.2016.064

Multiple sclerosis (MS) is a chronic autoimmune disorder affecting the central nervous system through demyelination and neurodegeneration. Autoreactive lymphocytes penetrate the blood-brain barrier to attack the nervous system. Fingolimod was approved as the first oral treatment for relapsing forms of MS. Its active metabolite, formed by in vivo phosphorylation, modulates sphingosine 1-phosphate receptors (S1PRs) and retains autoreactive lymphocytes in lymph nodes. It means unique mechanism of action which is different from the other immunomodulatory or immunosuppressive drugs. By the laboratory monitoring of immunotherapy in patients with MS it is...

Case report

Possibility of surgical treatment of lumbar spinal stenosis in the elderly

MUDr. Michael Mrůzek, MUDr. Tomáš Paleček, Ph.D., doc. MUDr. Radim Lipina, Ph.D.

Neurol. praxi. 2016;17(5):315-319 | DOI: 10.36290/neu.2016.065

The autors evaluate the results of surgical treatment for lumbar spinal stenosis in patiens over 65 years of age. The group included 72 patients, of whom 31 women and 41 men, the average age of 69.7 years. Type of Surgery has always chosen so that the patient is burdened as little as possible postoperative complications and allow for rapid vertikalization. From the surgical techniques were performed laminectomy with or without instrumentation, simple decompres-sion or indirect decompression through the introduction of an interspinous implant. Patients were followed for 5 years. It was evaluated ODI, VAS and ODOM score and claudication interval prolongation.

Use of pregabalin in clinical practice

MUDr. Jolana Rojíčková

Neurol. praxi. 2016;17(5):320-322 | DOI: 10.36290/neu.2016.066

Pain in diabetic polyneuropathy is a pharmacologically difficult-to-manage condition that tends to be resistant to treatment with both non-steroidal anti-inflammatory drugs and common analgesics. Antidepressants and antiepileptics are the first-choice drugs. Pregabalin is an antiepileptic drug derived from gabapentin that has been shown to reduce the intensity of neuropathic pain (Richter et al., 2005). It is a structural lipophilic GABA analogue, which readily crosses the blood-brain barrier. The mechanism of action likely involves an ability to bind to the α2 δ-subunit of a voltage-gated presynaptic calcium channel, by which pregabalin...

Impact of levodopa/carbidopa intestinal gel treatment on the quality of life and ability

PhDr. Nikoleta Poliaková, PhD., PhDr. Simona Lipovská, RNDr. Vladimír Meluš, PhD., doc. MUDr. Ján Bielik, CSc.

Neurol. praxi. 2016;17(5):323-327 | DOI: 10.36290/neu.2016.067

to work in patients with Parkinson's disease Background: The quality of life is becoming a respected medical phenomenon reflecting the impact of treatment on the patient's health condition. Evaluation of the quality of life by a patient can be used as a quite reliable assessment of the effectiveness of a treatment. The potential of impact of therapy with levodopa/carbidopa intestinal gel on the quality of life and ability to work in patients with Parkinson's disease has not yet been published in the Czech Republic. Methods: The research was conducted through the original questionnaire for patients using patient-reported outcomes (PRO). The results...

Video case reports

NBIA – neurodegeneration with brain iron accumulation

MUDr. Lenka Hvizdošová, MUDr. Michaela Kaiserová, Ph.D., prof. MUDr. Petr Kaňovský, CSc., doc. MUDr. Marek Baláž, Ph.D.

Neurol. praxi. 2016;17(5):328-332 | DOI: 10.36290/neu.2016.068

Neurodegeneration with brain iron accumulation (NBIA) is a heterogeneous group of genetically-linked neurodegenerative diseases characterized by increased iron accumulation in the basal ganglia. They present with a combination of extrapyramidal symptoms with deterioration of cognitive functions. In most cases, they are diseases with onset in childhood, but adult-onset or late-onset forms are also described. In this paper, we present an overview of recent data on individual types of NBIA with an emphasis on clinical and radiologic findings. In conclusion, we describe a case of a patient with suspected late-onset NBIA.