Neurology for Practice, 2021, issue 1
Editorial
Slovo úvodem
prof. MUDr. Ivan Rektor, CSc., FCMA, FANA, FEAN
Neurol. praxi. 2021;22(1):3 
Main topic
Neurologické poruchy ve stáří
doc. MUDr. Robert Rusina, Ph.D.
Neurol. praxi. 2021;22(1):8-10 | DOI: 10.36290/neu.2021.002
Vertigo and postural instability in old age
MUDr. Jiří Polívka, CSc., MUDr. Pavel Potužník, Ing. Jiří Polívka, Ph.D.
Neurol. praxi. 2021;22(1):11-16 | DOI: 10.36290/neu.2021.008
Vertigo is a frequent and serious problem in the elderly. It is a cause of postural instability and falls, resulting in pain, fractures, immobility, depression, and even death. The review article clarifies the terms vertigo and dizziness as well as the reasons for their increasing incidence and prevalence in old age. The term "presbystasis" is explained. The most common causes are cardiovascular (of these, postural hypotension) and vestibular (of these, benign paroxysmal positional vertigo). They are followed by visual, somatosensory system, central nervous system, and musculoskeletal system disorders, psychiatric causes, and medications, particularly...
Gait disorders in the elderly
MUDr. Hana Brožová, Ph.D.
Neurol. praxi. 2021;22(1):17-20 | DOI: 10.36290/neu.2021.020
Gait disorders in the elderly include changes associated with natural aging and pathological gait patterns based on diseases, which increase with age. The article provides an overview of the main causes of gait deterioration in the elderly and the most common types of gait disorders associated with neurological disease. The practical outcome is focused on the gait disorders detection in medical office and the possibilities of the management within a multidisciplinary cooperation.
Cognitive changes in old age: how to know that we are aging normally and how to age successfully
doc. MUDr. Martin Vyhnálek, Ph.D., Mgr. Tomáš Nikolai, Ph.D., prof. MUDr. Jakub Hort, Ph.D., prof. MUDr. Jan Laczó, Ph.D.
Neurol. praxi. 2021;22(1):21-26 | DOI: 10.36290/neu.2020.106
Physiological aging is associated with some loss of cognitive function, which however does not lead to self-insufficiency, but may still have consequences for complex activities of daily living. In the review paper we characterize these changes in cognition, we present the possibilities of differentiating physiological and pathological aging due to Alzheimer's disease and other neurodegenerative diseases, and we summarize the possibilities of prevention of pathological aging and cognitive decline in old age.
Headaches - an up to date problem even in elderly age
MUDr. Rudolf Kotas, Ph.D.
Neurol. praxi. 2021;22(1):27-33 | DOI: 10.36290/neu.2020.105
This paper describes specific problems of headache in seniors. The occurrence of primary headaches (migraine, tension - type headache, cluster headache) decreases with increasing age, the occurrence of secondary headaches (organic or metabolic diseases) increases, certain types of headaches occur almost exclusively in the elderly (giant cell arteritis, hypnic headache). Although treatments for most common primary headaches are available, age-related physiologic changes, comorbidities, contra indications, polypharmacy and increased risk of side effects require appropriate treatment in the elderly. Specific problems of acute and prophylactic treatment...
Age and just allocation of resources
PhDr. David Černý, Ph.D.
Neurol. praxi. 2021;22(1):34-39 | DOI: 10.36290/neu.2021.009
This article deals with the problem of resource allocation in the context of the aging of the human population. First, it focuses on a specific example of the allocation of scarce resources during the covid-19 pandemic and describes the role of patient age during it. Then it moves on to the general theory of resource allocation, which draws on the work of the American ethicist Norman Daniels. Within this theory, age plays an important role, but it cannot be understood as a case of ageism or negative discrimination.
Review articles
The influence on long-term progression of multiple sclerosis - brighter days ahead?
MUDr. Dominika Šťastná, doc. MUDr. Dana Horáková, Ph.D.
Neurol. praxi. 2021;22(1):40-44 | DOI: 10.36290/neu.2020.104
Multiple sclerosis (MS) is a chronic disease of the central nervous system. It is characterized by autoimmune inflammation, progressive demyelination and neurodegeneration. The characteristics of inflammation and the representation of these processes are variable over time and interindividual. Nevertheless, certain specific common features allow the division of MS into several phenotypes. However, the absence of a precise boundary makes determining the transition to secondary progression complicated. Clinical examination and the contact with the patient is fundamental. Evaluation of disability using EDSS should be enriched at least with a screening...
Statins and neuroprotective effects
prof. MUDr. Ivana Štětkářová, CSc., MHA, PharmDr. Aleš Dvořák, MBA
Neurol. praxi. 2021;22(1):45-49 | DOI: 10.36290/neu.2020.067
Statins are used to treat primary hypercholesterolemia and dyslipidemia. They significantly reduce cardiovascular risk in primary and secondary prevention. In the Czech Republic, atorvastatin and rosuvastatin are the most used drugs, otherwise simvastatin and fluvastatin are less prescribed. For statin therapy, appropriate HDL cholesterol target values should be established, and special regimen with adjunctive therapy with ezetimibe in selected patients. Drug side effects may occur with statin therapy, such as nausea, fatigue, myalgia, rarely statin myopathy. A number of studies have shown that statins have neuroprotective effects on the brain tissue....
From the boundary of neurology
Comprehensive interdisciplinary rehabilitation care in individuals with multiple sclerosis
Mgr. Klára Novotná, Ph.D., MUDr. Ingrid Menkyová, MUDr. Martina Kövári, MHA
Neurol. praxi. 2021;22(1):50-55 | DOI: 10.36290/neu.2021.019
Multiple sclerosis (MS), a chronic neurodegenerative disease, is the most common cause of disability in young adults. Regular fitness exercises and rehabilitation therapy can partially aid in preventing or treating the neurological symptoms. Given the heterogeneity and the interindividual variability in the severity of MS symptoms, it is optimal to provide rehabilitation through an interdisciplinary team. The aim of this article is to describe the current possibilities of interdisciplinary rehabilitation therapy.
Case report
Posttraumatic hydrocephalus
MUDr. Lubomír Jurák, Ph.D., doc. MUDr. Vladimír Beneš, Ph.D., prof. MUDr. Petr Suchomel, Ph.D.
Neurol. praxi. 2021;22(1):56-60 | DOI: 10.36290/neu.2021.021
Posttraumatic hydrocephalus is an active and progressive process of excessive accumulation of cerebrospinal fluid due to impaired dynamics of cerebrospinal fluid caused by traumatic brain injury. The incidence of posttraumatic hydrocephalus is given in the literature in a very wide range of 0.7-86 %, which is the result of differences in the diagnostic criteria and classification. A 32-year-old patient was admitted after a fall on inline skates at the nape area. His entering condition was assessed as Glasgow Coma Scale 4 with right-sided mydriasis. Brain computed tomography revealed acute subdural hematoma frontotemporoparietally above right hemisphere...
Development of quadriparesis after delirium: simple routine or diagnostic challenge?
MUDr. Eva Gödöllová, MUDr. Júlia Travkina, MUDr. Katarína Surmajová, MUDr. Tatiana Hučeková, MUDr. Monika Plevová, MUDr. Oto Petrík, MPH
Neurol. praxi. 2021;22(1):63-66 | DOI: 10.36290/neu.2020.010
Chronic lead poisoning is a rare form of secondary coproporphyria. Porphyrias belong to the group of rare metabolic diseases caused by a congenital enzymatic defect or an acquired disorder of heme synthesis. Lead has an inhibitory effect on enzymes involved in heme synthesis. All initial symptoms of chronic poisoning are non-specific and easily overlooked. Severe chronic poisoning may be accompanied by damage to the nervous system. We report a case of a patient with an atypical clinical pattern of delirium in alcohol overuse with neuropsychiatric and internal complications. The aim of the paper is to highlight the importance of detailed history and...
Company information
Fixed combination of paracetamol and tramadol in the practice: a case report
MUDr. Pavlína Nosková, Ph.D.
Neurol. praxi. 2021;22(1):68-71 | DOI: 10.36290/neu.2021.011
A fixed combination of paracetamol and tramadol per tablet enhances analgesic efficacy and reduces side effects of the individual components. This expands the portfolio of analgesics to treat acute and chronic pain, especially in elderly and at-risk patients. The article concludes by describing the practical use of analgesics in the treatment of back pain.
From the History of Neurology
Baron Constantin Economo von San Serff (1876-1931) and his encephalitis: war fighter pilot, neuroscientist, and the greatest medical mystery of the 20th century
doc. MUDr. Kateřina Menšíková, Ph.D., FEAN, prof. MUDr. Karel Šonka, DrSc., prof. MUDr. Petr Kaňovský, CSc., FEAN
Neurol. praxi. 2021;22(1):73-82
Constantin Economo was born in 1876, into a rich Greek patrician family in the city of Brãila, Romania. His father was a merchant with extensive properties in Thessaly and Macedonia, where in the city of Edessa his family was rooted; Economo's ancestors included several bishops of the Greek Orthodox Church. In 1877, the family moved to Trieste where Economo spent his childhood and youth. After his school-leaving exam in 1893, he started to study at the Polytechnic University of Vienna at the request of his father, but switched to medicine after two years. While still studying, he published his first scientific paper on the development of the pituitary...