Slovo úvodem

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

Neurol. praxi. 2023;24(3):163  

Vzácnější autoimunitní onemocnění CNS

prof. MUDr. Petr Marusič, Ph.D.

Neurol. praxi. 2023;24(3):167  

Autoimmune encephalitides

MUDr. David Krýsl, Ph.D.

Neurol. praxi. 2023;24(3):168-179 | DOI: 10.36290/neu.2023.020  

Autoimmune encephalitides (AIE) are autoimmune diseases of the central nervous system with predominant involvement of the cerebral cortex. The prevalence of AIE is comparable to that of encephalitis of infectious etiology. They can occur as paraneoplastic syndromes (in which the abnormal immune response is triggered by the presence of a peripheral tumor) or as non-paraneoplastic syndromes (where a combination of a viral trigger and an innate disposition seems to play a role). The most common AIEs include encephalitis with antibodies to glutamate N-methyl-D-aspartate receptors (NMDAR encephalitis), limbic encephalitis with antibodies to leucine-rich...

Autoimmune leukoencephalopatis with predominant brain involvement

MUDr. Martin Elišák, Ph.D., MUDr. Hana Mojžišová, doc. MUDr. Aleš Tomek, Ph.D., FESO

Neurol. praxi. 2023;24(3):180-186 | DOI: 10.36290/neu.2023.035  

Leukoencephalopathies can be difficult to diagnose. Diagnosis must focus on treatable causes. However, in addition to vascular, infectious and autoimmune causes, there are an increasing number of treatable genetic disorders. In the case of autoimmune encephalopathies, diagnosis and treatment have improved in recent years, allowing patients to be treated more quickly and effectively. Although there are still many unanswered questions about the mechanism by which the immune system attacks brain tissue, a better understanding of this mechanism will enable targeted immunotherapy to be chosen and prevent the possible worsening of the disease if the wrong...

Neurological disorders predominantly involving brainstem and cerebellum

prof. MUDr. Pavel Štourač, Ph.D.

Neurol. praxi. 2023;24(3):187-192 | DOI: 10.36290/neu.2023.030  

Paraneoplastic, autoimmmune and idiopathic syndromes of brainstem and cerebellum are usually of paraneoplastic origin. The diagnostics are based on the detection of onconeural antibodies, neural cell surface antibodies and imaging methods. The early diagnostics is based on the index of clinical suspicion and enables effective treatment in some cases.

Autoimmune myelitis

doc. MUDr. Dana Horáková, Ph.D., MUDr. Petra Nytrová, Ph.D.

Neurol. praxi. 2023;24(3):193-199 | DOI: 10.36290/neu.2023.025  

Autoimmune myelitis represents an etiologically heterogeneous group of inflammatory disorders of the spinal cord with acute or subacute onset. For a correct diagnosis, evaluation of objective findings and urgent imaging examinations (MRI of the spinal cord and brain, or at least CT if contraindicated) are essential. The examination of cerebrospinal fluid (especially to decide on infectious or other etiology), or other auxiliary examinations including determination of organ-specific and non-specific autoantibodies, plays an indispensable role. Once an infectious etiology has been ruled out, autoimmune inflammations affecting the CNS (multiple sclerosis,...

Laboratory biomarkers - neural antibodies in autoimmune diseases of the central nervous system

MUDr. Hana Mojžišová, MUDr. Martin Elišák, Ph.D., prof. MUDr. Petr Marusič, Ph.D.

Neurol. praxi. 2023;24(3):200-205 | DOI: 10.36290/neu.2023.019  

Neural antibodies belong to biomarkers of autoimmune disorders of CNS. They include antibodies against intracellular and surface neural antigens, with a separate category of glial antigens. Diagnostic possibilities are broad, interpretation of the results is, however, not always simple. As there is a possibility of false positive and negative results, the recommendation is to use two different methods of detection and examine both serum and cerebrospinal fluid samples. Diagnosis should always be based on a synthesis of clinical and laboratory findings. In case of inconclusive results (negative antibodies in a clear clinical suspicion or positive antibodies...

Long­‑term efficacy and safety of siponimod in patients with secondary progressive multiple sclerosis: Analysis of EXPAND core and extension data

doc. MUDr. Zbyšek Pavelek, Ph.D., prof. MUDr. Martin Vališ, Ph.D.

Neurol. praxi. 2023;24(3):206-211 | DOI: 10.36290/neu.2023.005  

Siponimod significantly reduced the risk of confirmed disability progression, worsening in cognitive processing speed, relapses, and magnetic resonance imaging measures of brain atrophy and inflammation in secondary progressive multiple sclerosis patients. Data from the 5-year extension of the EXPAND study support the importance of early detection of secondary progressive multiple sclerosis and thus early initiation of siponimod treatment.

Central neurogenic hyperthermia

MUDr. Veronika Kissiová

Neurol. praxi. 2023;24(3):212-217 | DOI: 10.36290/neu.2023.015  

Fever is a common phenomenon within neurological intensive care units. Etiologically, it is most often an infectious cause, to a lesser extent, non-infectious causes come into consideration such as thromboembolism, medically induced condition, postoperative causes and, last but not least, central neurogenic hyperthermia. This is a diagnosis per exclusionem, which does not yet have standardized diagnostic criteria or treatment. Likewise, the pathomechanism of its formation is not fully clarified. The article deals with an overview of available data from the physiology of thermoregulation, lays out the presumed pathophysiological background of...

B-cell targeted therapy to impact the progression of multiple sclerosis

MUDr. Martin Elišák, Ph.D.

Neurol. praxi. 2023;24(3):218-221 | DOI: 10.36290/neu.2023.040  

Monoclonal antibodies against CD20+ lymphocytes represent a highly effective treatment of multiple sclerosis by rapidly suppressing activity conditioned mainly by inflammatory processes. The progressive component of the disease presents a therapeutically more difficult problem - inflammation compartmentalizes beyond the blood-brain barrier, inflammation becomes diffuse, and degenerative processes play a role. Although the best effect of treatment is when it is started as early as possible, some patients may have progression from the beginning of the disease or are diagnosed at an advanced stage of the disease. Depletion of CD20+ lymphocytes may delay...

Subcutaneous form of levodopa - new device assisted treatment of Parkinson's disease

doc. MUDr. Marek Baláž, Ph.D., MUDr. Petra Havránková, Ph.D., doc. MUDr. Kateřina Menšíková, Ph.D.

Neurol. praxi. 2023;24(3):223-226 | DOI: 10.36290/neu.2023.031  

More than 50 years since the first clinical use of levodopa there has been no mini-invasive way of administration which would maintain a stable level of levodopa in patients´s body. This has now changed with phosphorylated levodopa, co called phospholevodopa which is soluble in water and therefore can be injected subcutaneously using a pumps. Owing to the subcutaneous application this therapeutic method is expected to spread into clinical practice. The authors summarise the aspects of the development and clinical information of the drug.

Cerebrospinal fluid cytology in the diagnosis of neurological diseases

RNDr. Kateřina Klíčová

Neurol. praxi. 2023;24(3):227-230 | DOI: 10.36290/neu.2022.055  

Cerebrospinal fluid analysis is an important part of the diagnosis of many diseases and is used across many medical disciplines. The changes that take place in the central nervous system are reflected in the composition of the cerebrospinal fluid. A wide range of laboratory methods is used for cerebrospinal fluid analysis, one of which is cytological analysis. Cerebrospinal fluid cytology makes it possible to obtain valuable information about the processes taking place in the central nervous system of the examined patient in a relatively short period of time and with common means. Quantitative and qualitative cytology is a simple and technically undemanding...

A rare syndrome where our multidisciplinary approach significantly helped the patient

MUDr. Alexandra Jungová, Ph.D., Dr. Evgeni D. Kavrakov

Neurol. praxi. 2023;24(3):232-235 | DOI: 10.36290/neu.2023.006  

In this case report we present the diagnostic process and treatment of a patient with severe chronic polyneuropathy (lasting around 3months), lymfadenopathy. hepatosplenomegaly, hypertrichosis and other symptoms. The patient´s condition required consultations with a neurologist, a hematologist, an ophtalmologist and also with a rehabilitation specialist and infectologists. The diagnose classic chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) was considered in the beginning due to relevant clinical manifestations. Intravenous immunoglobulins did not lead to significant clinical improvement of the polyneuropathy. Afterwards, it was found...

Budeme moct předepisovat „atomoxetin“?

MUDr. Ondřej Škoda, Ph.D., FESO

Neurol. praxi. 2023;24(3):238 | DOI: 10.36290/neu.2023.042  

Má význam pro profylaxi migrény B2?

MUDr. Jolana Marková, FEAN

Neurol. praxi. 2023;24(3):237 | DOI: 10.36290/neu.2023.041