Neurology for Practice, 2017, issue 3
Editorial
Slovo úvodem
prof. MUDr. Ivan Rektor, CSc.
Neurol. praxi. 2017;18(3) 
Závrat
doc. MUDr. Štefan Sivák, PhD.
Neurol. praxi. 2017;18(3)
Main topic
Chronic subjective dizziness
doc. MUDr. Jaroslav Jeřábek, CSc., PhDr. Ondřej Čakrt, Ph.D.
Neurol. praxi. 2017;18(3):149-151 | DOI: 10.36290/neu.2017.079
Chronic subjective dizziness (CSD) is defined as a state of non-rotating dizziness, uncertainty, or oversensitivity to one’s own movements or comprehensive motor stimuli. It typically develops after vestibular pathology has resolved. The patient makes the impression of not being able to readapt following the resolution of the acute phase of the disease and their motion patterns remain identical to those in the acute phase of the disease. This condition is often accompanied by profound anxiety that can gradually gain prominence in the clinical presentation.
Nonvestibular dizziness
prof. MUDr. Egon Kurča, PhD.
Neurol. praxi. 2017;18(3):152-155 | DOI: 10.36290/neu.2017.023
Dizziness is a symptom that, in human medicine, is probably second only in frequency to pain. As understood by patients as well as some physicians, the term dizziness often has different meanings. The basic interpretation of dizziness is impaired perception of the position and movement of one’s body in space. On the basis of aetiology, dizziness is divided into vestibular and nonvestibular vertigo. The present article deals with dizziness states of nonvestibular aetiology.
Episodic dizziness and vertigo
doc. MUDr. Štefan Sivák, PhD.
Neurol. praxi. 2017;18(3):156-160 | DOI: 10.36290/neu.2017.022
Episodic dizziness/vertigo or episodic vestibular syndrome is characterized by recurrent attacks of dizziness/vertigo with a duration of several seconds, minutes, or even hours, with periods of remission. It is a common problem in patients. Episodic dizziness/ vertigo can occur due to a variety of causes, including vestibular or primarily nonvestibular, peripheral or central, benign as well as life-threatening ones. Patients usually present in a period between the attacks; therefore, the correct diagnosis is based on a thorough history with an emphasis on temporal characteristics of the dizziness/vertigo, the presence of precipitating causes and associated...
Laboratory methods for investigating the vestibular apparatus
MUDr. Rudolf Černý, CSc., PhDr. Ondřej Čakrt, Ph.D., doc. MUDr. Jaroslav Jeřábek, CSc.
Neurol. praxi. 2017;18(3):163-169 | DOI: 10.36290/neu.2017.080
The paper presents a review of current options for objective evaluation of the function of the vestibular labyrinth, oculomotor function, and postural stability. Particular attention is paid to newly introduced methods of quantitative assessment using the head impulse test and testing of the otolithic apparatus by means of vestibular evoked myogenic potential.
Vestibular rehabilitation
PhDr. Ondřej Čakrt, Ph.D., doc. MUDr. Jaroslav Jeřábek, CSc.
Neurol. praxi. 2017;18(3):170-173 | DOI: 10.36290/neu.2017.081
Vestibular rehabilitation is a set of exercises that accelerate the process of vestibular compensation and allowing adaptation to existing vestibular pathology. These techniques utilize CNS neuroplasticity, leading to a recalibration of the sensory system. In order for rehabilitation to be successful, an individual rehabilitation plan has to be devised with respect to the test results of examinations, symptoms and patient´s present complaints.
Review articles
Vitamin D and multiple sclerosis
MUDr. Eva Krasulová, Ph.D.
Neurol. praxi. 2017;18(3):174-178 | DOI: 10.36290/neu.2019.037
Multiple sclerosis (MS) represents severe autoimmune disease of the central nervous system, typically afflicting young people in productive age. Disease etiology is not exactly known, however negative impact of low vitamin D serum level on disease onset and progression is undoubted so far. Moreover significant vitamin D deficit is a problem of two thirds of population in our latitude. The article summarizes up-to-date knowledge about vitamin D and its connection with MS including supplementary recommendation.
New perspectives of the treatment of migraine
MUDr. Rudolf Kotas, Ph.D.
Neurol. praxi. 2017;18(3):179-185 | DOI: 10.36290/neu.2017.082
The acute treatment of migraine attacks is so far limited to the use of simple analgesics, non-steroidal anti-inflammatory drugs, ergotamines and triptans. On the basis of our knowledge about pathophysiology of migraine, which is mentioned in this article, new medicaments for the treatment of acute migraine attacks have been developed targeted especially to calcitonin gene–related peptide (CGRP) and serotonin 5-HT1F receptors. Other therapeutic targets are mentioned, such as glutamate, combination of 5-HT- 1B/1D receptors and neuronal nitric oxide synthesis and medicament influencing cortical spreading depression. In the prophylaxis of migraine,...
B cells as a target in the treatment of multiple sclerosis
MUDr. Luděk Hochmuth
Neurol. praxi. 2017;18(3):186-189 | DOI: 10.36290/neu.2017.026
B cells play important role in pathogenesis of multiple sclerosis. Pathogenic mechanisms include antigen presentation, pro- and anti-inflammatory cytokines production, B cells can differentiate to plasmatic cells producing autoantibodies and they can participate on creation of meningeal follicular structures in central nervous system (CNS). We can effectively influence the course of disease by therapeutic depletion through anti-CD20 antibodies. Efficacy and safety of this treatment were demonstrated in clinical studies with relapsing remitting and primary progressive multiple sclerosis.
From the boundary of neurology
Osmotic demyelination syndrome
MUDr. Michal Vodička
Neurol. praxi. 2017;18(3):190-195 | DOI: 10.36290/neu.2017.083
Central pontine myelinolysis is a demyelinating disease of the pons caused mainly by a rapid correction of hyponatremia. Disease manifests itself with neurologic and psychiatric symptoms and can imitate many other diseases. There is no specific therapy of choice, even though a number of therapeutic approaches have been tested with various degree of success.
Case report
Listeria meningitis after administration of alemtuzumab for relapsing-remitting multiple sclerosis
MUDr. Pavel Hradílek, Ph.D., MUDr. Petr Hon
Neurol. praxi. 2017;18(3):196-200 | DOI: 10.36290/neu.2017.084
Alemtuzumab (ALM) is a humanized monoclonal antibody intended for the treatment of patients with active relapsing-remitting multiple sclerosis. Treatment with this agent may be accompanied by some serious complications. Following this treatment, another autoimmune disease can develop and infectious complications of varying severity can also occur. The present case report describes the development of listeria meningitis in a female patient following a course of ALM for multiple sclerosis. Listeria meningitis is a bacterial infection whose source usually is contaminated food. Patients who have had treatment with ALM may be more vulnerable to this...
Company information
Botulinumtoxinum A: pharmacological prerequisites for therapeutic effect
MUDr. Jiří Slíva, Ph.D.
Neurol. praxi. 2017;18(3):212-215
Botulinumtoxin is one of the most poisonous neurotoxin produced by the bacterium Clostridium botulinum. This paper deals with the basic mechanism of action in the context of its potential for therapeutic use in muscle spasticity and other disorders. Since today there are several medicines containing botulinumtoxin, in the text, among others, their mutual differences have been addressed. These play an important role for different immunogenicity profiles.
Pharmacotherapy
TYSABRI – new management of risk factors
MUDr. Yvonne Benešová, Ph.D.
Neurol. praxi. 2017;18(3):202-206 | DOI: 10.36290/neu.2017.086
Natalizumab belongs to monoclonal antibodies. This is a high- efficacy drug, which substantially reduces the activity and leads to long-term stabilization of multiple sclerosis. However, the therapy is associated with a risk of developing progressive multifocal leukoencephalopathy (PML) in patients infected with the John Cunningham Virus. Standardized high-quality monitoring procedures, clinical assessments, magnetic resonance imaging monitoring and use of biomarkers enable risk stratification. Early detection of disease in asymptomatic stage substantially improves survival and reduce the functional outcomes.
Perampanel – what to do with it?
prof. MUDr. Ivan Rektor, CSc.,, MUDr. Ondřej Strýček
Neurol. praxi. 2017;18(3):208-211 | DOI: 10.36290/neu.2019.069
Fycompa® (perampanel – PER) is new antiepileptic drug with a specific mechanism of action, different from other drugs. It is well tolerated and its safety profile is favourable with minimum of adverse effects, which are mild to moderate intensity even in high doses. Its interactive potential is low and allow combined therapy with other antiepileptic drugs. Great advantage are perampanel pharmacokinetic characteristics, offering the convenience of once- daily administration. It is effective add-on therapy of focal epilepsy and primary generalized tonic-clonic seizures in idiopathic generalised epilepsy. Many open label extension studies...
Cases
Neurozobrazovací kazuistika
MUDr. Martin Pail, Ph.D., MUDr. Marta Pažourková, prof. MUDr. Milan Brázdil, Ph.D.
Neurol. praxi. 2017;18(3):201 | DOI: 10.36290/neu.2017.085
Laudatio
Prof. MUDr. Karel Urbánek, CSc., slaví osmdesátiny
Jan Mareš, Andrea Bártková, Petr Hluštík,, Petr Kaňovský, Pavel Otruba
Neurol. praxi. 2017;18(3):217-218