Slovo úvodem

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

Neurol. praxi. 2022;23(5):343  

Funkční neurologické poruchy

prof. MUDr. Milan Brázdil, Ph.D., FRCP - editor hlavního tématu

Neurol. praxi. 2022;23(5):347  

Functional movement disorders

MUDr. Tereza Serranová, Ph.D.

Neurol. praxi. 2022;23(5):348-354 | DOI: 10.36290/neu.2022.027  

Functional movement disorders are important source of disability. Diagnosis of functional movement disorders should be based on positive signs of inconsistency of motor symptoms and their incompatibility with an organic disorder and not on exclusion of other conditions. The role of neurologist involves the delivery of a positive diagnosis and an explanation that functional symptoms are genuine, common, and potentially reversible, and a long-term follow-up. Increasing evidence supports the efficacy of physiotherapy and psychotherapy alone or in combination. Psychiatrists should evaluate and treat psychiatric comorbidities such as anxiety and/or depression....

Psychogenic nonepileptic seizures

MUDr. Ondřej Strýček, Ph.D., prof. MUDr. Milan Brázdil, Ph.D.

Neurol. praxi. 2022;23(5):355-361  

Psychogenic nonepileptic seizures (PNES) are the second most common functional neurological disorder after movement disorders. They are paroxysmal pathological behavioral manifestations or experiences, which clinically resemble epileptic seizures or syncope. However, they do not have the same pathophysiological cause (i.e. electrophysiological correlate typical of seizures or hypoperfusion of the brain typical of syncope). Although it is a functional neurological disorder with characteristic features, its diagnose is often difficult. It usually lasts several years from the first attack to making a correct diagnosis, during which patients are inadequately...

Acquired functional speech and voice disorders

Mgr. Patrik Mackulin, prof. PaedDr. Zsolt Cséfalvay, PhD.

Neurol. praxi. 2022;23(5):362-366  

Acquired functional speech disorders (formerly known as psychogenic speech disorders, psychosomatic, conversion, non-organic voice disorders) are an individual subtype of functional neurological disorders, that include a broad scale of voice disorders, that are not understood well enough and therefore are poorly diagnosed in clinical practice or are often misdiagnosed. Acquired functional speech and voice disorders do not arise as a result of structural organic or neurological changes, but it is assumed that biopsychosocial factors may be behind their origin. In the clinical picture problems of these patients may occur in isolation or co-morbidity...

Supraspinal and cognitive-affective components in headaches

MUDr. Pavel Řehulka, Ph.D.

Neurol. praxi. 2022;23(5):367-371 | DOI: 10.36290/neu.2022.037  

Supraspinal mechanisms are involved in the patophysiology of the most common craniofacial pain disorders (migraine, tension-type headache, myofascial orofacial pain, idiopathic orofacial pain). These diseases are acquired and multifactorial, their developement involves genetic predisposition, hormonal influences and environmental factors (including the psychosocial stress). The exact neurobiological processes of the development of these diseases have not yet been fully elucidated. However, impairment on the both peripheral and central levels of the somatosensory system and the endogenous dysmodulation of nociceptive activity are involved. The bidirectional...

High-efficacy drugs in early stage of multiple sclerosis

MUDr. Veronika Tichá, Ph.D.

Neurol. praxi. 2022;23(5):373-378 | DOI: 10.36290/neu.2022.054  

The most commonly used treatment algorithm in multiple sclerosis (MS) is initiation with lower efficacy drugs, i.e. first-choice drugs, and, in case of their failure, escalation to drugs with higher efficacy, also known as HET (High Efficacy Treatment). The use of high-efficacy drugs at an early stage of the disease, however, appears to be a superior strategy in delaying progression and irreversible damage to the central nervous system. The favourable safety profile of these drugs allows to aim, from the very beginning of MS treatment, at complete stabilization of clinical parameters and of the finding on magnetic resonance imaging. However, the complicated...

Aromatic amino acid decarboxylase deficiency (AADC). Perhaps a more common cause of delayed psychomotor development than it might seem

MUDr. Lenka Knedlíková, MUDr. Pavlína Danhofer, Ph.D., MUDr. Senad Kolář, doc. MUDr. Hana Ošlejšková, Ph.D.

Neurol. praxi. 2022;23(5):381-386 | DOI: 10.36290/neu.2022.009  

Aromatic L-amino acid decarboxylase deficiency is a rare autosomal recessive disorder of neurotransmitter synthesis that leads to a severe combined deficiency of catecholamines, dopamine and serotonin. The disease occurs during infancy with developmental delay, hypotonia, movement disorder with oculogyric crises, vegetative symptoms and other manifestations. In general, little awareness of this disease, heterogeneous clinical manifestation and severity of the phenotype, along with methodologically complex diagnostics, often results in incorrect categorization of these patients and contributes to the fact that the disease remains underdiagnosed worldwide....

The role of corticosteroids in the treatment of epilepsy

MUDr. Klára Španělová, MUDr. Katarína Česká, MUDr. Štefánia Aulická, Ph.D.

Neurol. praxi. 2022;23(5):389-393  

The inflammatory processes in the brain are a part of the pathophysiological mechanism; involved in epileptogenesis, an onset of seizure activity and the development of drug resistance. The endogenous anti-inflammatory response fails, and the inflammation develops during recurrent seizures or status epilepticus. Thus, it plays a crucial role in the retaining seizure activity and the continuing seizures. A relation between inflammation and epilepsy is, therefore, reciprocal. Corticoids and ACTH partly mediate the anticonvulsant effect by their anti-inflammatory characteristics. The corticosteroids have achieved a wide range of use in epileptology, both...

Vaccination of patients with multiple sclerosis

MUDr. Daniel Dražan, MUDr. Tomáš Nečas

Neurol. praxi. 2022;23(5):395-399 | DOI: 10.36290/neu.2022.036  

Patients with multiple sclerosis have an increased risk of acquiring and complications of vaccine-preventable infections caused by the underlying disease and its treatment. Vaccines have not been shown to cause or worsen the course of multiple sclerosis. All patients with multiple sclerosis should be properly vaccinated as indicated by age and risk factors, including immunosuppressive therapy. However, the latter is a contraindication to the administration of live vaccines.

Regular monitoring of cognitive functions in multiple sclerosis

Mgr. Jiří Motýl, Ph.D., doc. MUDr. Tomáš Uher, Ph.D.

Neurol. praxi. 2022;23(5):400-405 | DOI: 10.36290/neu.2022.042  

Prevalence of cognitive impairment in multiple sclerosis (MS) is reported to be in range between 35% and 65%. Cognitive impairment in MS has usually a mild form with information processing speed and episodic memory being the most affected cognitive domains. Annual neuropsychological screening of people with MS can provide clinicians with useful data on disease activity and progression; even before the threshold for cognitive impairment is reached. Neuropsychological test batteries BICAMS, MACFIMS or the SDMT test are recommended as the tools of choice for neuropsychological monitoring of MS. The change in cognitive outcomes can be evaluated by Reliable...

Family with hereditary transthyretin amyloidosis - case report

MUDr. Tomáš Bauer

Neurol. praxi. 2022;23(5):406-411 | DOI: 10.36290/neu.2022.056  

Hereditary transthyretin amyloidosis is a rare disease with an often fatal course. Due to the currently available treatment options in the first stages, diagnostic vigilance and targeted search for patients with it is necessary. The article briefly summarizes the current knowledge about the disease, diagnostic pitfalls, the recommended treatment procedure and presents the case of the first family discovered in the Czech Republic.

Examination of subjective visual vertical by SVV bucket test

MUDr. Jan Heřman, MUDr. Tomáš Fürst, prof. MUDr. Richard Salzman, Ph.D.

Neurol. praxi. 2022;23(5):413-416 | DOI: 10.36290/neu.2021.016  

Objectives: To determine the tilt of subjective visual vertical (SVV) in healthy volunteers and in patients with peripheral vestibular syndrome by SVV bucket test. Evaluate the interindividual repeatability of the examination in patients of otoneurological clinic. Methodology: The results of SVV bucket test of 38 healthy volunteers and 42 patients with peripheral vestibulopathy were compared. We evaluated the interrater variability of the method by comparing the results of measurements of a doctor and a nurse in 153 patients of otoneurological clinic. Results: The average SVV in healthy volunteers was mostly less than 1°, not more than 2°. Significantly...

Cerebral venous thrombosis and the importance of farmacological history

MUDr. Zuzana Hanzelková, doc. MUDr. Ondřej Volný, Ph.D., MUDr. Jana Slonková, Ph.D., MUDr. Pavla Hanzlíková, Ph.D., prof. MUDr. Michal Bar, Ph.D.

Neurol. praxi. 2022;23(5):418-420 | DOI: 10.36290/neu.2021.078  

Cerebral venous thrombosis is a rare form of stroke that most commonly affects women of childbearing potential. The presentation of the case report points to the possible non-specificity of clinical symptoms and the importance of obtaining propper pharmacological history. The patient was examined for non-specific neck pain and headache. Native CT scan of the brain showed no structural pathology, no severe elevation of inflammatory parameters was found and a lumbar puncture ruled out neuroinfection. The diagnosis of cerebral vein thrombosis was only revealed by MRI angiography. Originally the patient did not mention taking of any medication, however...