Slovo úvodem

prof. MUDr. Ivan Rektor, CSc.

Neurol. praxi. 2019;20(4):243  

Poranění plexu a periferních nervů

doc. MUDr. Edvard Ehler, CSc., FEAN – editor hlavního tématu

Neurol. praxi. 2019;20(4):247 | DOI: 10.36290/neu.2019.124  

Reconstruction possibilities of injured brachial plexus

MUDr. Ivan Humhej, Ph.D., prof. MUDr. Martin Sameš, CSc.

Neurol. praxi. 2019;20(4):249-258 | DOI: 10.36290/neu.2019.125  

Surgical management of brachial plexus (BP) injuries has achieved significant evolution throughout the last decades. Currently, primary techniques of BP reconstruction (grafting, neurotization) along with secondary correction procedures (tendon transfers, free functional muscle transfers, arthrodesis, other bone/joint procedures), allow a high degree of functional recovery of the disabled limbs. The main requirement for achieving ideal therapeutic results, is a complex approach by a team of experienced specialists, tailored to each individual patient accordingly. Adequately planned long-term postoperative care is a crucial component of the therapeutic...

Traumatic lesions of peripheral nerves and brachial plexus in children

MUDr. Josef Kraus, CSc.

Neurol. praxi. 2019;20(4):261-266 | DOI: 10.36290/neu.2019.126  

Peripheral nerve injuries result from traffic, sports as well as leisure-time accidents. Assessment of nerve lesions in children is part of routine outpatient and consultant neurological practice at a traumatology ward. According to its extent, an injury can be partial or complete; according to prognosis, transient or permanent; depending on the cause, it can be blunt, sharp, open, traction, compression, and contusion; neurovascular or iatrogenic. Classification includes three basic types: neurapraxia, axonotmesis, and neurotmesis. The diagnostic procedure mainly involves identifying nerve compression or transection prior to its irreversible damage...

Peripheral nerve injury of the upper limb

MUDr. Jiří Ceé

Neurol. praxi. 2019;20(4):267-274 | DOI: 10.36290/neu.2019.127  

The most of neurologists deal with the peripheral nerve injury of the upper limbs (especially closed) in everyday practice. EMGexamination remains a gold standard for more accurate determination of the level of injury, importance of imaging methods alsohas been increased. The decision whether conservative or surgical treatment should be indicated depends on the mechanism andlevel of injury, results and dynamics of EMG results. No reliable procedure has been found to accelerate the axonal regenerationof the peripheral nerve.

Iatrogenic peripheral nerve damage

doc. MUDr. Edvard Ehler, CSc.

Neurol. praxi. 2019;20(4):276-280 | DOI: 10.36290/neu.2019.128  

Iatrogenic cause of disease is defined as a harmful response to medicamentous or surgical therapy. Iatrogenic peripheral nervelesions can be brought about with a surgical instrument in an operational field, but also with compression, traction, catching thenerve by splint, damage of nerve by bleeding or radiation. In the paper there is given an overview of the most frequently injuredperipheral nerves and situations, in which a iatrogenic lesion developes.

Evaluation of multiple sclerosis treatment efficacy in 21st century

MUDr. Eva Krasulová, Ph.D.

Neurol. praxi. 2019;20(4):282-286 | DOI: 10.36290/neu.2019.129  

Multiple sclerosis (MS) represents severe autoimmune disease of the central nervous system, typically afflicting young people in productiveage. Currently a large portfolio of modern drugs is available. These drugs are fundamentally modifying disease course, however weare still searching for optimal treatment effectivity and prognostic markers in an individual patient. The article summarizes all markersused in evaluation of treatment response and disease progression including composite marker NEDA (No Evidence of Disease Activity).NEDA corresponds to absence of clinical as well as radiological disease activity and is one of the...

Significance of multiple sclerosis early treatment

doc. MUDr. Ema Kantorová, PhD.

Neurol. praxi. 2019;20(4):288-290 | DOI: 10.36290/neu.2019.155  

Multiple sclerosis is a chronic disorder, which primarily affects young adults. Timing of treatment determines further evolution ofthe disorder and positively influences quality of life. The work brings new insides on diagnostics and treatment of the disorder.

A new era of multiple sclerosis treatment

MUDr. Marek Peterka

Neurol. praxi. 2019;20(4):292-295 | DOI: 10.36290/neu.2019.130  

Multiple sclerosis is very serious neurological disease. If not treated it causes severe disability of patients. New hope in treating MS arose in the nineties due to arrival of modern therapy. However only last couple decades have brought revolutionary changes in the treatment of this disease. Besides medicaments used continuously to affect the disease, we now have new specific therapeutic group called immune reconstitution therapy (IRT), which can induce long-term remission of the disease without continual treatment. New highly efficient therapy changes our views of goals in therapy of MS. Now our main goal is to achieve long-term remission of the...

Migraine – from pathophysiology to monoclonal antibodies

MUDr. Rudolf Kotas, Ph.D.

Neurol. praxi. 2019;20(4):296-300 | DOI: 10.36290/neu.2019.131  

This systematic review summarizes the clinical manifestations and the existing knowledge about the pathophysiology of migraine. In the pathophysiology of migraine the activation of trigeminovascular system and the release of calcitonin gene-related peptide (CGRP), substance P and neurokinin A plays the most important role. These mediators lead to the sterile perivascular neurogenic inflammation in meninges. The attention is targeted especially to the CGRP, which seems to be the key mediator in the pathophysiology of migraine. The most promising new approach in the prophylactic treatment are monoclonal antibodies able to block either CGRP or its receptor,...

Farmacotherapy of headache, mainly migraine

MUDr. Irena Novotná

Neurol. praxi. 2019;20(4):302-306 | DOI: 10.36290/neu.2019.132  

Headache is one of the most common disorders encountered by nearly everyone. It is primarily divided into primary, where the most typical variety is migraine and its forms, and secondary, where headache is a symptom of another illness and it accompanies this illness. After the illness is cured, headache most often disappears. Headaches are distinguished in detail according to International Headache Society classification. In a daily practice of a physician or farmacist, the most important classification is to primary and secondary headache. According to anamnesis, after excluding possible secondary reasons and with normal results of common support...

Uncontrolled seizures in adult epilepsy patients

MUDr. Jana Zárubová, prof. MUDr. Petr Marusič, Ph.D.

Neurol. praxi. 2019;20(4):307-311 | DOI: 10.36290/neu.2019.133  

There are still patients with epilepsy and uncontrolled seizures despite established treatment. It is dangerous, the risks depend on the type of seizure. It could be health and life-threatening. A refractory epilepsy may progressively impair brain structure and function. Patients are at higher risk of comorbidities, including injuries and accidents, higher mortality and psychosocial consequences. The goal of treatment is a patient without seizures. Only remission (5 years without seizures) reduces the described risks to the level of the general population. The task of the neurologist is to review the examinations and treatments selected so far, to...

Cortical inflammation in pathogenesis of multiple sclerosis

doc. MUDr. Vladimír Donáth, PhD.

Neurol. praxi. 2019;20(4):312-315 | DOI: 10.36290/neu.2019.134  

Multiple sclerosis is an autoimmune-related disease characterized by inflammation and neurodegeneration. Looking at inflammation,its characteristics, intensity and localization has undergone changes in recent years. Acute and chronic inflammationis present in all forms of SM. Cortical demyelination is an important pathological substrate for irreversible functional disability,progression and cognitive impairment. A comprehensive understanding of inflammatory manifestations can help us to set upindividualized therapy for the patient.

Proper treatment with improper diagnosis

MUDr. Eva Gödöllová, MUDr. Peter Bábel, MUDr. Katarína Surmajová, MUDr. Simona Repčíková, MUDr. Julia Travkina, MUDr. Oto Petrík, MPH

Neurol. praxi. 2019;20(4):316-319 | DOI: 10.36290/neu.2018.069  

The present case report describes a female patient with unrecognized giant-cell arteritis who had been receiving appropriatetreatment for years despite misdiagnosis. The patient had complained of polymorphous symptoms for twelve years and undergonevarious paraclinical tests based on which she received an incorrect diagnosis. Our case report aims to highlight the variedclinical presentation of systemic vasculitis which, when the results are misinterpreted, can mimic other diseases.

NEUROLOGOVÉ SE PTAJÍ…

Neurol. praxi. 2019;20(4):320-322