Neurology for Practice, 2020, issue 5

Editorial

Slovo úvodem

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

Neurol. praxi. 2020;21(5):339

Main topic

Bolest

prof. MUDr. Ivana Štětkářová, CSc., MHA, FEAN - editorka hlavního tématu

Neurol. praxi. 2020;21(5):343

Evaluating a patient with neuropathic pain in a neurological outpatient practice

doc. MUDr. Eva Vlčková, Ph.D., prof. MUDr. Josef Bednařík, CSc.

Neurol. praxi. 2020;21(5):344-348 | DOI: 10.36290/neu.2020.043

Pain represents one of the most frequent clinical symptoms. According to the recent epidemiological studies, most of one third of neurological patients suffer from pain. Both the neuropathic and/or nociceptive pain may occure in neurological patients and their differentiation is highly important (among others due to their different treatment). The diagnostic process in pain patient consists from several steps. The first one is based on the data from medical history and is focused on history of relevant neurological lesion or disease and presence of pain in neuroanatomically plausile distribution, and also on the pain character and intensity and pain-worsening...

Interventional management of chronic back pain

MUDr. Jan Lejčko

Neurol. praxi. 2020;21(5):350-355 | DOI: 10.36290/neu.2020.050

Epidemiological studies suggest that one of the most common areas of the human body affected by chronic pain is back. Back pain is one of the most common causes of doctor visits and have an enormous clinical, social and economic impact on our society. Lifestyle changes with a lack of physical activity are a major cause of increasing back pain. In the event of failure conventional therapy, interventional pain management procedures may apply. Interventions should be performed by a physician experienced and trained in invasive pain management - interventional pain specialist. Precise topical diagnosis of pain origin is a precondition for successful treatment....

Neuromodulation in the treatment of chronic pain

doc. MUDr. Jiří Kozák, Ph.D., MUDr. Ivan Vrba, Ph.D.

Neurol. praxi. 2020;21(5):356-362

Neuromodulatory approaches are among the selective methods of chronic pain management. In terms of their medical indication, its financial demands and operational approach, it ranks among the most challenging algesiological techniques from the economic and professional point of view. Neuromodulation includes both invasive and non-invasive methods. We describe the basic invasive methods - neurostimulation and intrathecally drug therapy using pump systems, their indications, basic uses and diagnoses in which these methods are most commonly used.

Central post-stroke pain

prof. MUDr. Ivana Štětkářová, CSc., MHA

Neurol. praxi. 2020;21(5):364-366 | DOI: 10.36290/neu.2020.113

Post-stroke pain may occur in post-stroke patients. A significant percentage of people develop headaches early after stroke, mostly of the tension type with tendency to chronicity. Central post-stroke pain (CPSP) occurs in 7-10% of patients after stroke. CPSP usually appears in 1-3 months after stroke; in most people 6 months later. The most important role in pathophysiology of CPSP play overactivity of the sympathetic nervous system, sensitization of the pain pathway, increased inflammatory response and local nerve tissue hypoxia, respectively. The lesion relates to the pain pathway, particularly in the thalamus, where a slight stimulus of the peripheral...

Pain in multiple sclerosis patients

MUDr. Marta Vachová

Neurol. praxi. 2020;21(5):369-371 | DOI: 10.36290/neu.2020.114

Pain belongs among the most disabling clinical symptoms of multiple sclerosis. Most frequent is chronic central neuropathic type of that. The best treatment option is anticonvulsants therapy by gabanoids or tricyclic antidepressants, but often the second or third line therapy have to been used. One of these next line therapies are the cannabinoids now. Managing of pain treatment needs the multidisciplinary team, including physio and psychotherapeutics. Other type of pain is neuromuscular due to changed movement stereotypes. The primary headaches, like migraine or tension type, occurred frequently.

Pharmacotherapy for neuropathic pain in adults

MUDr. Aneta Rajdová, doc. MUDr. Eva Vlčková, Ph.D.

Neurol. praxi. 2020;21(5):373-377 | DOI: 10.36290/neu.2020.092

Neuropathic pain is a severe clinical symptom of many different conditions affecting peripheral and central nervous system. Cancer-related and spondylogenic pain frequently has neuropathic component. Contrary to nociceptive pain, analgetics such as paracetamole or nonsteroid anti-inflammatory drugs are typically ineffective in neuropathic pain. All current foreign and Czech recommendations agree on the first-line treatment and partially on the other treatment lines. First line treatments include anticonvulsants, in particular α2δ subunit of voltage gated calcium channels ligands (gabapentin, pregabalin), serotonine-norepinephrine reuptake...

Review articles

Multiple sclerosis: adherence to treatment

MUDr. Zbyšek Pavelek, Ph.D., MUDr. Simona Halúsková, MUDr. Jana Šarláková, prof. MUDr. Martin Vališ, Ph.D.

Neurol. praxi. 2020;21(5):380-383 | DOI: 10.36290/neu.2020.078

Multiple sclerosis is a chronic inflammatory autoimmune disease which affect central nervous system. Treatment initiation of early multiple sclerosis may postpone the development of disease progression and disablement. Adherence to treatment fundamentally contributes to achieving optimal results of therapy, improving the quality of life of patients and reducing healthcare costs.

Differential diagnosis of amyotrophic lateral sclerosis

MUDr. Jana Cepková, MUDr. Aleš Kopal, MUDr. Leoš Ungermann, Ph.D., doc. MUDr. Edvard Ehler, CSc.

Neurol. praxi. 2020;21(5):384-389

Amyotrophic lateral sclerosis is characterized by an impairment of central and peripheral motoneurones. According to contemporary diagnostic criteria (Awaji-shima) on the basis of clinical findings and electrophysiological investigation there si possible to determine a probable or a definite diagnosis of ALS. A clasissical form of ALS with the beginning in the extremities or in the bulbar region with gradual generalization occures most frequently. In a differential diagnosis there is necessary to exclude the whole series of generalized disorders and for various focal forms of ALS also further neurological diseases.

Epidemiology of Parkinson's disease

MUDr. Tereza Bartoníková, doc. MUDr. Kateřina Menšíková, Ph.D., prof. MUDr. Vladimír Janout, CSc., prof. MUDr. Petr Kaňovský, CSc.

Neurol. praxi. 2020;21(5):390-394 | DOI: 10.36290/neu.2020.016

Idiopathic (sporadic) Parkinson's disease (PD) is one of the most frequent neurodegenerative disorders. The disease has heterogenous pfenotype and origin: both endogenous (genetic) and exogenous (enviromental) factors probably participate on manifestations of the PD and many other factors are involved. However, the exact pathophyziological cause has not been indentified yet. Therefore it is exceptionally important to collect all data which could help understanding the development of the Parkinson's disease. The epidemiological data can expose factors which can be further experimentally verified. It is essential to point out that relevant data about...

From the boundary of neurology

Use of functional electrical stimulation in adult neurological patients: how it can be used to manage gait issues

Mgr. Klára Novotná, Mgr. Jakub Jeníček, Ph.D.

Neurol. praxi. 2020;21(5):395-399

Introduction: Functional electrical stimulation (FES) of the peroneal nerve is used to improve gait in a large group of patients with central motor neuron disease. The aim of the article is to describe, based on available literature, how FES can be utilized in patients after stroke, brain or spinal cord injuries, or in those with multiple sclerosis (MS). Method: For the purpose of writing this article, specialist literature was searched using the PubMed database. Review articles and meta-analyses as well as articles comparing various groups of neurological patients were selected. Results: According to available literature, FES has a positive effect...

Case report

The most common errors in current migraine prophylaxis: case reports

MUDr. Ingrid Niedermayerová

Neurol. praxi. 2020;21(5):400-405 | DOI: 10.36290/neu.2020.100

Prophylactic treatment is administered in order to reduce the frequency, duration, and severity of migraine attacks. The treatment is typically initiated with antiepileptic drugs or beta blockers; it is further based on the presence of other conditions, for example psychiatric ones, risks of adverse effects, and contraindications, if any. The article uses case reports to discuss the most common errors in choosing a prophylactic agent with respect to comorbidities, the timing and duration of the treatment.

Controversy

Bolesti z nadužívání analgetik - detoxikace?

MUDr. Pavel Řehulka, Ph.D., MUDr. Zbyšek Pavelek, Ph.D.

Neurol. praxi. 2020;21(5):406-409 | DOI: 10.36290/neu.2020.117

Information

What type of data does the ReMuS National Multiple Sclerosis Patient Registry offer?

doc. MUDr. Dana Horáková, Ph.D.

Neurol. praxi. 2020;21(5):410-413 | DOI: 10.36290/neu.2020.101

Multiple sclerosis is a serious neurological disease that affects an estimated 20,000 patients in the Czech Republic. We are not yet able to cure the disease, the only effective prevention of irreversible disability is the timely initiation of anti-inflammatory therapy with continuous monitoring and adjustment of therapy according to individual activity of the disease. Data from real clinical practice are crucial for evaluating the efficacy and safety of treatment. In the Czech Republic since 2013, the regular collection of this data has been ensured by the nationwide ReMuS register, the founder of which is the Endowment Fund Impuls in cooperation...