Neurology for Practice, 2022, issue 6
Editorial
Slovo úvodem
prof. MUDr. Ivan Rektor, CSc., FCMA, FANA, FEAN
Neurol. praxi. 2022;23(6):427 
Main topic
Neuropsychiatrie a neuropsychologie
MUDr. Tereza Uhrová, Ph. D. - editorka hlavního tématu
Neurol. praxi. 2022;23(6):431
Agitated and aggressive patient in neuropsychiatry: Are we using non-pharmacological procedures correctly?
prof. MUDr. Jan Vevera, Ph.D.
Neurol. praxi. 2022;23(6):432-436 | DOI: 10.36290/neu.2022.057
Almost every healthcare worker meets patients with aggressive behavior, Deescalation is the way of behavior and communication which leads to a decrease of tension in the patient as well as caregivers. The first important step is an assessment of the situation. The safety of healthcare professional is essential. It is important to be aware of our own reactions, stay calm and find out real causes of agitation and violence. The second step is a correct communication based on informing patient about what happens and will happen which enhances his trust., don´t give an impulsive answer and identify the reason of patient's agitation. The consistency of verbal...
Indications for neuropsychological assessment in neuropsychiatry: are referrals for neuropsychological evaluation always effective?
doc. Mgr. Ondřej Bezdíček, Ph.D.
Neurol. praxi. 2022;23(6):437-441
The text aims at introducing the criteria for referral questions regarding neuropsychological assessment in clinical settings. A brief description of different referral questions including separate phases of neuropsychological assessment follows. We provide also an algorithm for choosing the right referral question for general practitioners and specialists as well.
Psychiatric disorders in patients with amyotrophic lateral sclerosis
MUDr. Jana Milerová, Ph.D.
Neurol. praxi. 2022;23(6):442-446
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease leading to muscle weakness and death within 2-5 years. In the absence of a causal treatment, care focuses on reducing the concomitant complications of ALS. Psychiatric issues in ALS patients are common and neglected in clinical practice. The disorders described here - behavioral and cognitive symptoms of frontotemporal degeneration, pseudobulbar affect, and depressive and anxiety disorders - negatively modify the course of the underlying disease, shorten survival time, significantly exacerbate the suffering of ALS patients, and substantially reduce the quality of life and...
Non‑pharmacological treatments in neuropsychiatry
doc. MUDr. Marek Baláž, Ph.D., prof. MUDr. Tomáš Kašpárek, Ph.D., doc. MUDr. Lucie Kališová, Ph.D., prof. MUDr. Jan Chrastina, Ph.D.
Neurol. praxi. 2022;23(6):447-450
Non-pharmacological methods in neuropsychiatry include biological approaches (invasive and noninvasive stimulation of central nerve system structures), psychotherapy and psychoeducation. Range of diseases treated by non-pharmacological methods is wide and with improvements of accessibility the use of these methods will probably grow.
Review articles
Application of antiCGRP prophylaxis episodic and chronic migraines in praxis
MUDr. Petra Migaľová
Neurol. praxi. 2022;23(6):453-460
Migraine is the third most common neurological disease. It i also one of the most disabling disease in the world. They are around one million patients with migraine in the Czech Republic. At least 50 000 women and men suffer from chronic migraine. Since 1993, we have a specific acute antimigraine drug, triptans. Since 2020, targeted biological treatment has been available, which significantly reduces the number of migraine attacks and improves the patient's quality of life.
Primary neurology healthcare and prescription drug addiction
MUDr. Petr Polidar
Neurol. praxi. 2022;23(6):463-467 | DOI: 10.36290/neu.2022.001
Meeting a patient using no medicaments regularly has become a curiosity in the 21st century. Considering the increasing number of chronic diseases we become more and more aware with the phenomenon of polypragmasia, which may result in damaging the patient. With recent advances in new and multimodal drug development we may usually reduce the number of prescription drugs used by the patient. This method however demands enough time, which we don't have an abundance of. Even more so, discontinuation of some treatment options may be very poorly tolerated by a patient. The relatively new science of Addictology is a multidisciplinary field specializing...
Benefit of optical coherence tomography (OCT) in the diagnosis, monitoring of disease activity and response to treatment in patients with multiple sclerosis
MUDr. Miriama Skirková, MUDr. Monika Moravská, MUDr. Marek Horňák, MUDr. Jozef Szilasi, doc. MUDr. Jarmila Szilasiová, PhD.
Neurol. praxi. 2022;23(6):470-476
Optical coherence tomography (OCT) is a non-invasive imaging method of retinal structures that can be used in the diagnosis and monitoring of multiple sclerosis activity, especially imaging the reduction of total macular volume and thinning of the peripapillary retinal nerve fiber layer. The severity of these deficits is proportional to the progression of the patient's disability. The parameters of optic nerve and retinal ganglion cell neurodegeneration correlate with the degree of brain atrophy and the disease activity expressed by NEDA-status.
Long-term efficacy and safety of ofatumumab in the treatment of multiple sclerosis
MUDr. Marek Peterka
Neurol. praxi. 2022;23(6):477-482 | DOI: 10.36290/neu.2022.050
The treatment of multiple sclerosis (MS) has gone through significant progress in last couple of years. Although the presence of oligoclonal bands in the liquor is one of the keys for the diagnosis of MS, the function of B lymphocytes in the pathophysiology of this disease has been long time underestimated. Only the invention of drugs that cause B-lymphocyte depletion has demonstrated their ability to suppress disease activity of this diseases. We currently have another drug from this group called ofatumumab. This is the first fully human monoclonal antibody available for the treatment of relapsing-remitting forms of MS. The aim of this article is...
Eptinezumab - the new anti-CGRP monoclonal antibody for prophylactic treatment of migraine
MUDr. Rudolf Kotas, Ph.D.
Neurol. praxi. 2022;23(6):483-487
Calcitonin gene-related peptide (CGRP) plays a key role in the pathophysiology of migraine. Eptinezumab is the first intravenous monoclonal antibody targeting the molecule of CGRP which is used for the preventive treatment of migraine. In this paper the pharmacology of eptinezumab and five successful Phase III clinical studies are reviewed. The study PROMISE-1 evaluates the efficacy, safety and tolerability of eptinezumab in the preventive treatment of episodic migraine, the study PROMISE-2 is the same in chronic migraine. The study PREVAIL evaluates the long-term safety, immunogenicity and patient-reported efficacy with help of standard questionnaires...
From the boundary of neurology
Biologics targeting CD20 molecule on B cells in the therapy of multiple sclerosis patients
prof. RNDr. Jan Krejsek, CSc.
Neurol. praxi. 2022;23(6):488-491 | DOI: 10.36290/neu.2022.045
B cells are substantially contributing into the adverse inflammatory reaction mediated by abnormally polarized Th1 and Th2 subsets of T cells in the immunopathogenesis of multiple sclerosis (MS). B cells are able to recognize (auto)antigens via specific receptors. Activation and clonal expansion of B cells is in addition supported by PRR receptors identifying damage associated molecular patterns (DAMP) and(or) patterns of microbial invasion (PAMP). Ectopic highly organized lymphatic tissue are found in CNS of MS patients. B cells are potent antigen presenting cells stimulating specific T cells thus contributing to their clonal expansion and abnormal...
Case report
Non‑aneurysmal subarachnoid hemorrhage in a patient with Moamoya syndrome - case report
MUDr. Lubomír Jurák, Ph.D., doc. MUDr. Vladimír Beneš, Ph.D. III, prof. MUDr. Petr Suchomel, Ph.D.
Neurol. praxi. 2022;23(6):493-497 | DOI: 10.36290/neu.2021.060
Choroba či syndrom moyamoya by měl být zvažován v rámci diferenciální diagnostiky jako příčina subarachnoidálního krvácení, pokud není jako jeho potenciální zdroj nalezena jiná zřejmá cévní patologie. Moyamoya disease is a chronic cerebrovascular disease characterized by progressive stenosis and/or occlusion of the intracranial internal carotid and its proximal branches with a created abnormal collateral network of small arteries. If the vascular occlusion is not bilateral and the patient has been diagnosed with a specific underlying illness, we refer to this condition as Moyamoya syndrome. The presentation of Moyamoya disease or syndrome in the form...
Cerebellar mutism - a case report
MUDr. Lenka Pospíšilová, prof. MUDr. Martin Vališ, Ph.D., FEAN
Neurol. praxi. 2022;23(6):499-502 | DOI: 10.36290/neu.2022.002
Cerebellar mutism is a postoperative complication after an intervention in posterior cranial fossa. It can particularly be seen in children following tumor resection of cerebellar vermis. Clinical features of this syndrome are well described in foreign literature while its pathophysiology stays unclear. The goal of our case report is to point this interesting phenomenon out mainly because it is only sporadicly mentioned in Czech neurological publications.
Cortico-responsive encephalopathy as a complication of autoimmune thyroiditis
MUDr. Kateřina Dvorníková, MUDr. Jana Slonková, Ph.D., doc. MUDr. Ondřej Volný, Ph.D., MUDr. Jana Horáková, prof. MUDr. Michal Bar, Ph.D.
Neurol. praxi. 2022;23(6):504-506 | DOI: 10.36290/neu.2021.091
Steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT) is a rare syndrome characterised by neuropsychiatric symptoms, high antithyroid antibodies and rapid clinical response to corticosteroids. We present a case of a patient admitted for hospitalisation for acute disorientation, perceptive speech disorder and incoherence of thinking, with a history of hyperthyreosis without recent concomitant therapy. CT and MRI brain scans were not diagnostically conclusive. Thyroid hormones and anti-thyroid antibodies were collected as part of a wider differential diagnosis. Anti-thyroid peroxidase (anti-TPO) antibodies were strongly positive....
Conversation
13 nejčastějších otázek k NSA aneb jak si poradit v praxi?
Gedeon Richter Marketing ČR, s. r. o.
Neurol. praxi. 2022;23(6):508-510