Slovo úvodem

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

Neurol. praxi. 2020;21(6):423  

Tremor - slovo úvodem

doc. MUDr. Matej Škorvánek, PhD. - editor hlavního tématu

Neurol. praxi. 2020;21(6):427  

Clinical classification of tremor

prof. MUDr. Evžen Růžička, DrSc., MUDr. Petr Hollý

Neurol. praxi. 2020;21(6):428-432 | DOI: 10.36290/neu.2020.090  

Tremor is the most common abnormal movement, occurring as a single symptom or in combination with other movement disorders. This review article provides an insight into the clinical classification of tremor according to the latest consensus recommendation. The main emphasis is placed on the description of the symptoms and syndromes of tremor and the diagnostic criteria of its principal clinical entities, designated for everyday neurological practice.

Neurophysiological methods in examination of tremor

doc. MUDr. Michal Minár, PhD.

Neurol. praxi. 2020;21(6):434-438 | DOI: 10.36290/neu.2020.065  

Tremor is the most common movement disorder and it can be a symptom of many pathological conditions. According to its etiology, we choose adequate therapy, so accurate and early diagnosis is essential. In addition to a detailed medical history and precise clinical examination, neurophysiological methods - especially electromyography, but also electroencephalography or evoked potentials - provide valuable information. Considering the focus of the journal, we will deal mainly with the use of neurophysiology in daily clinical practice.

Pharmacological therapy of tremor

doc. MUDr. Matej Škorvánek, PhD.

Neurol. praxi. 2020;21(6):439-442  

Tremor is the most common movement disorder with essential tremor as the most frequent disorder associated with tremor affecting approximately 4 % of population. None of the standardly used medications has been developed specifically in the indication for tremor and none of the currently used pharmacological interventions allows modification of the disease course of most disorders associated with tremor except rare diseases such as Wilson's disease. First choice medications for limb tremor include propranolol, primidone and topiramate. This review will outline the basic principles and algorithms of pharmacological management of different tremor entities...

Surgical treatment of tremor

MUDr. Martin Nevrlý, Ph.D., MUDr. Jan Bardoň, doc. MUDr. David Krahulík, Ph.D., MUDr. Pavel Otruba, MBA, prof. MUDr. Petr Kaňovský, CSc., FEAN

Neurol. praxi. 2020;21(6):444-446  

Tremor is often a disabling symptom in various neurological diseases. Even though the majority of these are incurable, there is at least a possibility of symptomatic management of tremor in a high number of patients. A conservative approach consisting in pharmacotherapy is always the first choice; however, it is of little effect in a not insignificant number of patients with tremor. In a proportion of these patients, surgical treatment is the method of choice. Currently, the method of deep brain stimulation is used most widely, but some promising results of non-invasive lesion techniques have also become available.

Negative prognostic factors in multiple sclerosis

MUDr. Jiří Piťha

Neurol. praxi. 2020;21(6):448-452 | DOI: 10.36290/neu.2020.098  

Multiple sclerosis is a heterogeneous disease with a variable prognosis. The choice of optimal treatment in the initial stages of the disease fundamentally affects its further course. It is an effort to find the most ideal prognostic factors that would differentiate patients at risk of higher clinical activity and progression of disability with the need to introduce more vigorous treatment. These indicators include demographic and clinical factors, magnetic resonance imaging findings, some laboratory biomarkers, and environmental factors. More information is provided by a comprehensive assessment of the forecast based on multivariate prediction models....

Epilepsy in patients with dementia

MUDr. Eva Pešlová, prof. MUDr. Milan Brázdil, Ph.D.

Neurol. praxi. 2020;21(6):454-459 | DOI: 10.36290/neu.2020.038  

Epileptic seizures are more prevalent in patients with dementia in comparison to normal aging population. Incidence of seizures depends on the aetiology and level of progression. Studies on the patients with Alzheimer´s dementia show wide range of epilepsy prevalence between 4 and 47 % depending on the patient group and the study design with the highest prevalence in the early onset autosomal dominant Alzheimer dementia. Both the diagnostics and treatment of epilepsy in dementia are quite specific. Diagnostics require cooperation with the caregivers and repeated EEG examination ideally with preceding sleep deprivation. The most important recommendations...

Vestibular migraine

MUDr. Lukáš Martinkovič, doc. MUDr. Jaroslav Jeřábek, CSc.

Neurol. praxi. 2020;21(6):460-463 | DOI: 10.36290/neu.2020.081  

Vestibular migraine is a clinical entity used to describe paroxysmal vestibular disorders associated with migraine. It is a common cause of episodic vertigo, but the diagnosis is not well known in clinical practice. It occurs in all age categories, predominant in women. It is a heterogeneous disease and there is no definitive test to confirm its diagnosis. Ménière´s disease, benign paroxysmal positional vertigo (BPPV) or vascular diseases in the posterior fossa should be excluded within differential diagnosis. Antiemetics and analgesics are administered as acute symptomatic therapy. Depending on the severity, frequency and duration of clinical...

Diabetic polyneuropathy treatment

MUDr. Milan Grofik, PhD., MUDr. Michal Cibulka, PhD., prof. MUDr. Egon Kurča, PhD., FESO

Neurol. praxi. 2020;21(6):466-471  

Diabetic polyneuropathy is the most frequent complication of diabetes mellitus and at the same time the most common cause of diabetic foot syndrome and pain in patients with diabetes. This disorder is still being diagnosed insufficiently and too late in many cases. Therapeutic intervention in early stages could slow down (or completely stop) progression of the neuropathy. Presented paper reviews current possibilities of prevention and therapy of diabetic polyneuropathy as well as pharmaceuticals and nutraceuticals that were, or still are involved in clinical trials.

Diagnostic and therapeutic algorithms in vertiginous patients

doc. MUDr. Jaroslav Jeřábek, CSc.

Neurol. praxi. 2020;21(6):472-476  

Vertigo is a serious differential diagnostic problem. Particularly in acute vertigo, serious undrelying condtions, like stroke in vertebrobasilary circulation must be excluded. Despite this fact, majority of vertiginous problems are not life threatening. Based on knowledge of basic diagnostic algorhitms, correct diagnosis and treatment of vertigo can be done in outpatient care.

Idiopathic inflammatory myopathies - new advances

prof. MUDr. Jiří Vencovský, DrSc.

Neurol. praxi. 2020;21(6):477-484 | DOI: 10.36290/neu.2020.069  

Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of diseases affecting striated muscle and several other organs. Significant numbers of patients have autoantibodies in serum that are specific for myositis subtypes and associate with disease course and prognosis. New classification criteria for IIM use weighted assessment of disease related parameters and allow calculation of percentage disease probability. Lately, new criteria for dermatomyositis subtypes have been proposed based largely on the detection of myositis specific autoantibodies. New criteria for clinical response to treatment have been developed in 2017. These criteria...

The most significant side effects of non-opioid analgesics and their pharmacological mechanisms

PharmDr. Bc. Hana Kotolová, Ph.D., MUDr. Jana Nováková, Ph.D.

Neurol. praxi. 2020;21(6):485-490 | DOI: 10.36290/neu.2020.108  

Analgesics belong to the most commonly prescribed drugs. Non-opioid analgesics are drugs of various chemical origin that have analgesic, antipyretic and some of them also have anti-inflammatory and antiaggregation effect. They can be divided into analgesics - antipyretics and non-steroidal anti-inflammatory drugs. Inhibition of cyclooxygenase and thus influencing the formation of eicosanoids is a common mechanism of action, especially in nonsteroidal antiphlogistics. Both desirable therapeutic effects and side effects are associated with the influencing of eicosanoid production.

Susac's syndrome

MUDr. Jiří Piťha, MUDr. Marta Vachová, MUDr. Jana Kotalová, MUDr. Markéta Ceé

Neurol. praxi. 2020;21(6):491-494  

Susac's syndrome (SS) is an autoimmune disease characterized by the clinical triad of encephalopathy, arterial retinal occlusion, and neurosensory hearing loss based on microangiopathy affecting the precapillary arterioles of the brain, retina and inner ear. SS is characterized by a typical radiological finding on MRI, which, together with clinical symptoms, may allow diagnosis. Retinal artery occlusion is best evaluated by fluorescein angiography, which may exhibit typical multifocal fluorescence. SS is an autoimmune endothelopathy that requires long-term treatment with corticosteroids, immunosuppressants, or even monoclonal antibodies, in acute cases...

Raeder paratrigeminal syndrome with aneurysm at the carotid siphon

MUDr. Václav Boček, Ph.D., MUDr. Jan Paták, MUDr. Iva Julia Bělohoubková, MUDr. Martin Kerekanič, MUDr. Jiří Fiedler, Ph.D.

Neurol. praxi. 2020;21(6):495-498  

The clinical manifestation of a growing aneurysm poses a differential diagnostic challenge in terms of topical as well as aetiological neurological diagnosis. The aim of this paper is to report the case of a female patient with a growing aneurysm at the left carotid siphon presenting as Raeder syndrome, a less frequently described entity in the Czech literature. Following successful endovascular treatment, there was a regression in the patient's complaints. The paper also deals with the differential diagnosis of the symptomatology of the parasellar region.

Results of a multicenter clinical observation: Concentrix® and its use in patients with attention deficit/hyperactivity disorder

MUDr. Michaela Habalová, Mgr. Anna Marie Jičínská, Mgr. Veronika Gondžová, Mgr. Nela Nováková, RNDr. Tomáš Pavlík, Ph.D., Bc. Monika Mazalová, MUDr. Hana Medřická, MBA, Mgr. Dana Chmelařová⁴, doc. MUDr. Hana Ošlejšková, Ph.D.

Neurol. praxi. 2020;21(6):499-504 | DOI: 10.36290/neu.2020.127  

Attention deficit/hyperactivity disorder is the most common neurodevelopmental disorder of childhood. The clinical symptoms vary with the age of a child. The diagnosis is established by the presence of core symptoms, ie. attention deficit, hyperactivity and impulsivity. The therapy of the disease is multidisciplinary, using regime adjustment, psychotherapy and pharmacological approaches. Based on ethiopathogenesis, which is complex, the use of new nutritional supplements is being tested, in an effort to reduce clinical symptoms. This trend is probably due to the detection of changes in lipid profiles in the nervous system in patients with Attention...

Je možné ukončit péči o pacienta pro hrubé porušení léčebného režimu?

JUDr. Šárka Špeciánová

Neurol. praxi. 2020;21(6):505-506