Slovo úvodem

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

Neurol. praxi. 2022;23(4):263  

Vrozené vady

MUDr. Josef Kraus, CSc. - editor hlavního tématu

Neurol. praxi. 2022;23(4):269-270 | DOI: 10.36290/neu.2022.065  

Malformations of cortical development and their epilepsy surgery

MUDr. Martin Kudr, Ph.D., MUDr. Martin Kynčl, Ph.D., prof. MUDr. Pavel Kršek, Ph.D.

Neurol. praxi. 2022;23(4):273-277  

Congenital malformations of cortical development (MCD) are frequent underlying pathology of focal structural epilepsies in children as well as adults. MCDs form a broad group of disorders ranging from well-localized lesions in focal cortical dysplasia (FCD) type II, through lobar and multilobar involvement in FCD types I and II, to extensive malformations affecting one or both hemispheres (hemimegalencephaly, lissencephaly). Pharmacoresistance, which is defined as the failure of two adequately selected anti-seizure drugs at the maximum tolerated doses, is reported in 65% of patients with MCD. For many patients with MCD epilepsy surgery is the only...

Genetic causes of malformations of cortical development - novel insights into pathogenesis and diagnostic approach

MUDr. Barbora Straka, Ph.D., MUDr. Markéta Vlčková, Ph.D., MUDr. Miroslava Balaščaková, Ph.D., RNDr. Lenka Krsková, Ph.D.

Neurol. praxi. 2022;23(4):278-283  

Although respective types of malformations of cortical development (MCD) are rare, patients with all MCD constitute a significant proportion of neurology in- and outpatient clinics. Genetic testing of blood- or brain tissue-derived DNA can elucidate genetic causes of MCD and thereby influence future patient management and reproductive choices of patients and their families. High-quality MRI and detailed phenotype description constitute the cornerstone of MCD diagnostic process. Genetic testing and analysis may take months, and functional studies of variants in novel genes, previously not associated with MCD may last even longer.

Neuroendoscopy in congenital inborn defects

doc. MUDr. Petr Libý, Ph.D.

Neurol. praxi. 2022;23(4):284-291 | DOI: 10.36290/neu.2022.028  

This paper focuses on the use of neuroendoscopy for treatment of selected central nervous system developmental defects in children. It introduces neuroendoscopic armamentarium, methods and some conditions suitable for a neuroendoscopic approach in pediatric neurosurgery.

The most frequent congenial and developmental disorders of the spine and spinal cord in the lumbosacral region

MUDr. Miloslav Holub, MUDr. Jana Blažková

Neurol. praxi. 2022;23(4):292-295 | DOI: 10.36290/neu.2022.046  

Congenital and developmental disorders of the spine and spinal cord in the lumbosacral region in childhood are affections divided into two main groups - spina bifida aperta and spina bifida occulta. These dysrapisms in many cases significantly affect the motor and sensitive functions of the lower limbs, deterioration of urine and faeces. We present the most frequent clinical units, their diagnosis and treatment.

Long­‑term effect of siponimod on MRI outcomes in patients with secondary­‑progressive multiple sclerosis

MUDr. Simona Halúsková, prof. MUDr. Martin Vališ, Ph.D., FEAN

Neurol. praxi. 2022;23(4):296-303 | DOI: 10.36290/neu.2022.041  

Secondary-progressive multiple sclerosis (SP-MS) is the second most common form of MS worldwide. While there are various disease-modifying drugs indicated for relapsing-remitting MS, effective treatment for SP-MS was lacking. Siponimod, a selective modulator of sfingosin-1-phosphate receptors, is the first oral drug to treat SP-MS, which showed a statistically significant decrease in confirmed disability progression in a phase III clinical trial. Magnetic resonance imaging (MRI) has a major role in establishing the diagnosis of MS along with being the most important tool for monitoring the course of the disease. Data from the ongoing open-label extension...

Ischaemic stroke in childhood

MUDr. Jaroslava Paulasová Schwabová, MUDr. Lukáš Paulas

Neurol. praxi. 2022;23(4):306-311  

Although rare, stroke in childhood is among the most common causes of paediatric mortality and permanent neurological deficit. Diagnostic and therapeutic procedures similar to those utilized in adults cannot be used in paediatric acute care. Nevertheless, raising awareness of acute treatment options, including recanalization techniques, and rapid diagnosis may significantly improve the clinical outcomes in the future even in this age group.

Ocrelizumab since the first multiple sclerosis attack - a milestone in reimbursement criteria

MUDr. Dominika Šťastná, MUDr. Ingrid Menkyová, doc. MUDr. Dana Horáková, Ph.D.

Neurol. praxi. 2022;23(4):312-316  

When intensive treatment is initiated before the inflammation behind the blood-brain barrier is closed, the potential to affect multiple sclerosis is the greatest. Thus, early initiation of high efficacy therapy appears to be the best therapeutic strategy for most patients, and thanks to the change in reimbursement criteria, this strategy can be chosen in the Czech Republic too. However, in a minority of patients with mild forms of the disease, there is no reason to take a safety risk and the appropriate choice is an escalation strategy. The choice can be made based on prognostic markers, but these are not perfect and the price for insufficiently intensive...

The influence of aging on course multiple sclerosis on climacteric and menopausal women

MUDr. Olga Zapletalová

Neurol. praxi. 2022;23(4):319-322  

Multiple sclerosis is a chronic inflammatory disease of the central nervous system leading to demyelination and neurodegeneration. The disease is clearly more common in women. Being a women is one of the strongest risk factors for multiple sclerosis. Menopause is one of the evolutionary stages that all women experience trough aging and this fenomenon exposes them to massive changes. Boath healthy and RS women could have some healthy problems. In clinical practice, symptoms of MS and menopause can frequently overlap. The presence of MS does not appear to influence age of menopausal onset, but MS disability during and after menopause seems to worsen....

Migraine treatment in patients with poor compliance

MUDr. Jana Múdra

Neurol. praxi. 2022;23(4):324-329 | DOI: 10.36290/neu.2022.035  

Compliance is a key factor in the treatment of many chronic diseases. In the dictionary it means agreement, willingness, consistency and cooperation. Adherence has similar meaning. Poor treatment adherence is associated with poor results and decreases with the complexity of the treatment. Inadequate usage of headache treatment, including overuse of medication as well as underuse, can exacerbate headaches and is a risk factor for the development of chronic migraine. Despite the importance of treatment adherence, there are very few studies that have examined adherence of patients suffering from migraine. Available studies indicate that acute and prophylactic...

Is it stroke or glioblastoma?

MUDr. Lukáš Hruška

Neurol. praxi. 2022;23(4):330-332 | DOI: 10.36290/neu.2022.049  

This case report is about patient with acute onset of amentia with uncertain hypodensity on CT scan of the brain. Initial diagnosis of stroke was made, but more precise imaging methods and investigations proved that it was glioblastoma. Acute onset of neurological symptoms together with hypodensity on initial CT scan of the brain may suggest stroke. Some symptoms and lesions on imaging methods are just mimicking stroke including intracranial tumors and their tumor attacks. In case of uncertain initial finding it is recommend to provide CT scan with contrast, eventually MRI. Perfuse CT scan and MRI with PWI and TDI sequence may be effective to distinguish...

Presence of occlusion in azygos anterior cerebral artery as a cause of rare bifrontal ischemia - casuistics

MUDr. Filip Verbovský, MUDr. Ladislav Gurčík, PhD., MUDr. Matúš Ferenc, MUDr. Matúš Rutkay

Neurol. praxi. 2022;23(4):333-335  

Thanks to technological progress of modern medicine, it is possible to visualize vascular abnormalities in brain arterial circulation by standard examination procedures. With regard to their clinical significance these vascular anomalies demonstrate wide variability - from asymptomatic and often accidental findings to the occurrence of disabling neurological conditions in the form of ischemic or hemorrhagic stroke. It is essential to identify detailed vascular anatomy and pathology in a particular patient in order to plan and carry out interventional endovascular, vascular surgical or neurosurgical procedures. The aim of this article is to clarify...

Neuromyelitis optica imitating astrocytoma

MUDr. Kryštof Švub, MUDr. Kamila Revendová, doc. MUDr. Ondřej Volný, Ph.D., MUDr. Pavel Hradílek, Ph.D., MUDr. Olga Zapletalová, RNDr. Pavlína Kušnierová, Ph.D., prof. MUDr. Michal Bar, Ph.D.

Neurol. praxi. 2022;23(4):336-338 | DOI: 10.36290/neu.2021.057  

Our case report presents a 23-year-old young female who was admitted to the Department of Neurology at the University Hospital Ostrava for further investigation of progressive central quadruparesis and a finding of an elongated spindle-shaped lesion with affection of the spinal gray matter in the cervical and rostral thoracic spinal segments on a T2 weighted magnetic resonance imaging. In a differential diagnosis process of a patient with an extensive spinal cord hypersignal lesion on T2 weighted images it is important to take into our diagnostic considerations a diagnosis from the neuromyelitis optica spectrum disorders, and both the anti-aquaporin...