Slovo úvodem

prof. MUDr. Ivan Rektor, CSc.

Neurol. praxi. 2017;18(2)  

Urgentní stavy v neurologii

MUDr. Petr Hon

Neurol. praxi. 2017;18(2):82 | DOI: 10.36290/neu.2017.072  

amence, delirium, lucidita, obnubilace, porucha vědomí, vigilita, ABCDE algoritmus, Glasgow coma scale

MUDr. Roman Havlíček, MUDr. Martin Voldřich, Ph.D.

Neurol. praxi. 2017;18(2):84-86 | DOI: 10.36290/neu.2018.064  

Disorders of consciousness accompany a wide range of diseases, involving almost all branches of medicine. Despite different etiology, in the first contact with the patient we should follow a standardized diagnostic approach in order to distinguish the acutest cases. In less serious cases we have more time for diagnostics – detailed medical history and further investigations help us to discover the cause of the problem. The border between the urgent medicine procedures and observation are defined by the stability of the patient. The aim of this article is not to give a review of anatomy, physiology and neurological examination. It should...

Status epileticus in adults in neurointensive care

MUDr. Ivana Šarbochová, MUDr. Lukáš Martinkovič

Neurol. praxi. 2017;18(2):88-93 | DOI: 10.36290/neu.2019.009  

epilepticus (SE) is an urgent neurological condition with high morbidity and mortality regardless intensive health care. Early identification of SE with the rapid initiation of its treatment can influence the outcome. The proposed concept of SE according to International League Against Epilepsy (ILAE) includes an assessment of clinical diagnosis with its timeline and adequate therapeutic approach. Despite aggressive therapy the refractory SE with necessity to use general anesthesia and artificial ventilation is developed in one third of patients. While clinical recognition of convulsive status is not difficult, the diagnosis of nonconvulsive status...

Intracerebral hemorrhage

MUDr. Martin Šrámek

Neurol. praxi. 2017;18(2):94-97 | DOI: 10.36290/neu.2017.071  

Intraparenchymal hemorrhage (ICH) accounts for 10–20 % of all strokes, its mortality is much higher compared to ischemic strokes. 55 % of hematomas are localised deeply in brain hemisphere, 30 % in lobes and 15 % in the brain stem. The most frequent causes of ICH are hypertensive vasculopathy, amyloid angiopathy, vessel malformation or tumors. ICH patients should be admited to an ICU, the goal of therapy is blood pressure normalisation using intravenous drugs, coagulopathy treatment in patients on anticoagulation therapy and cerebral edema treatment. Prophylactic antiseizure medication is not recommended. Surgical treatment is effective...

Intensice care in patients with Guillain-Barré syndrome

MUDr. Petr Hon

Neurol. praxi. 2017;18(2):98-102 | DOI: 10.36290/neu.2017.070  

Acute polyradiculoneuritis – Guillain – Barré syndrome (GBS) is the most frequent peripheral nerves illnes, requiring neurointensive care. About 30 % patients have respiratory dysfunction and need ventilatory support. Specific for this disease is vegetative nerves dysfunction with hemodynamic lability, gastrointestinal complication, need for long lasting mechanical ventilation in full consciousness patient. Early recognition of respiratory failure, adequate intensive care in unite dispensing with possibility of complex care is the basic condition of succesfull therapy.

Smoking and multiple sclerosis

doc. MUDr. Radomír Taláb, CSc., MUDr. Marika Talábová

Neurol. praxi. 2017;18(2):103-108 | DOI: 10.36290/neu.2017.050  

Multiple sclerosis (MS) is a chronic inflammatory disease wherein demyelination and axonal loss occur in the central nervous system (CNS). MS is a multifactorial disease in which environmental factors can be responsible for triggering an autoimmune response in genetically susceptible individuals. Environmental factors typically act in combination, while being less selective and having an effect on the pathogenesis of MS. A complex interplay between individual genetic predisposition and environmental factors in MS affects both the incidence of MS and its clinical form. The most significant factors include smoking, reduced vitamin D concentration,...

Dysphagia after anterior cervical discectomy

MUDr. René Opšenák, doc. MUDr. Branislav Kolarovszki, PhD., MUDr. Juraj Šutovský, MUDr. Martin Benčo, PhD., MUDr. Romana Richterová, PhD., MUDr. Pavol Snopko

Neurol. praxi. 2017;18(2):109-112 | DOI: 10.36290/neu.2017.073  

Swallowing difficulties after anterior cervical discectomy are a common and well-known complication in the postoperative period. Pathophysiology of dysphagia after surgery is unclear, and the treatment of persistent dysphagia is problematic. Published incidence of dysphagia following cervical discectomy is in the range of 0–89 %, and decreases with increasing time after surgery. Factors that are usually associated with increased risk of dysphagia after surgery include: multiple level surgery, female gender, long surgery duration and age over 60 years. It is possible to quantify dysphagia after anterior cervical discectomy with subjective...

Dravet syndrome (severe myoclonic epilepsy of infancy – SMEI): characteristics of adulthood

MUDr. Pavlína Danhofer, MUDr. Katarína Brunová, doc. MUDr. Hana Ošlejšková, Ph.D.

Neurol. praxi. 2017;18(2):113-116 | DOI: 10.36290/neu.2017.074  

Dravet syndrome (DS) is ranked among severe epileptic syndromes with occurence in the first year of life in normal children. It can be diagnosed according to the clinical course, genetics can be very helpful by assessing the mutation in SCN1A gene, which is responsible for 70–80 % of cases with DS. Other mutations were identified more rarely (SCN2A, SCN3A, SCN7A, SCN8A a SCN9A, GABARG2, SCN1B and PCDH19). Dravet syndrom in adulthood is characterised by cognitive and behavioral changes in patients with various rate of mental retardation, language deficit and cerebellar symptomatic. The course of epilepsy is milder, the rate of seizure freedom...

Botulinum toxin type A for the migraine prophylactic treatment Botulinum toxin type A for the migraine prophylactic treatment

MUDr. Andrea Bártková, Ph.D.

Neurol. praxi. 2017;18(2):117-120 | DOI: 10.36290/neu.2017.130  

Chronic migraine (CM) is a neurological disease that remains underdiagnosed and difficult to treat. In the comparison with episodic migraine, patients with CM show a higher degree conditional functional limitation, reduced work productivity and quality of life. This personal and socioeconomic burden emphasizes the urgent need for adequate treatment. Although we commonly use a wide range of oral preventatives in the clinical practice, currently the only the Food and Drug Administration (FDA) approved treatment for CM prevention is onabotulinumtoxin A. In this review, we discuss history and present perspectives of this therapy.

Hair loss due to treatment of multiple sclerosis

MUDr. Radek Litvik, MUDr. Olga Zapletalová

Neurol. praxi. 2017;18(2):121-125 | DOI: 10.36290/neu.2019.042  

The treatment of patients with multiple sclerosis, uses a variety of drugs that can adversely affect the structure and function of the hair, especially the negative influence of the anagen phase of the hair cycle. Hair loss is reversible in most patients, very rarely we can see expressions of irreversible baldness. The treatment is mostly applied topical minoxidil.

Bickerstaff's autoimmune brainstem encephalitis

MUDr. Petra Plachá, prof. MUDr. Petr Kaňovský, CSc., MUDr. Michaela Kaiserová, Ph.D., MUDr. Sandra Kurčová

Neurol. praxi. 2017;18(2):126-129 | DOI: 10.36290/neu.2017.075  

Bickerstaff´s autoimmune brainstem encefalitis (BBE) is, together with Miller-Fisher syndrome (MFS) and Guillain-Barré syndrome (GBS), subdued as one of the autoimmune associated diseases affecting the nervous system. In case of Bickerstaff´s encephalitis the structure affected by inflammation is the brainstem, with the corresponding clinical features . We report a case of 60-year-old female patient who developed, within a few months a gait disturbance, paleocerebellar and neocerebellar symptoms, internuclear ophalmoplegia with dissociated nystagmus, bilateral nuclear lesion of the facial nerve and bulbar symptoms. Magnetic resonance (MR) imaging...

What was hiding behind a migraine attack?

MUDr. Anna Šefčíková, MUDr. Miloslav Dvorák, PhD.

Neurol. praxi. 2017;18(2):130-132 | DOI: 10.36290/neu.2017.076  

The case report presents a 60-year-old patient with a history of hypertension, ischaemic heart disease, hyperlipoproteinaemia, and long-standing migraine, who was admitted to our department for a prolonged migraine attack not responding to normally effective therapy. In the course of hospitalization, the patient developed diplopia and left oculomotor nerve lesion, with subsequent bilateral, progressive deterioration in vision. Laboratory and additional paraclinical testing revealed leptomeningeal carcinomatosis as well as a newly diagnosed gastric B-cell lymphoma.

Coincidence of corticobasal syndrome and cerebellar form of multiple system atrophy

MUDr. Michal Minár, PhD., MUDr. Zuzana Košutzká, MUDr. Peter Matejička, MUDr. Igor Straka, prof. MUDr. Peter Valkovič, PhD.

Neurol. praxi. 2017;18(2):134-136 | DOI: 10.36290/neu.2017.002  

The article presents case reports of two patients with an atypical presentation of two distinct neurodegenerative diseases. After 60 years of age, both the patients gradually developed signs of corticobasal syndrome, which included levodopa-resistant, markedly asymmetrical akinetic-rigid parkinsonism with dystonia, myoclonia, and focal cortical deficit. In addition, these patients had cerebellar syndrome with an MRI finding of cerebellar and pontine atrophy, with progressive development of vegetative dysfunction. Based on the clinical presentation and imaging studies, a rare coincidence of corticobasal syndrome and the cerebellar form of multiple system...

Neurozobrazovací kazuistika

MUDr. Martin Pail, Ph.D., MUDr. Marta Pažourková, prof. MUDr. Milan Brázdil, Ph.D.

Neurol. praxi. 2017;18(2):138 | DOI: 10.36290/neu.2017.077