Neurology for Practice, 2023, issue 4
Editorial
Slovo úvodem
prof. MUDr. Ivan Rektor, CSc., FCMA, FANA, FEAN
Neurol. praxi. 2023;24(4):243 
Main topic
Paroxyzmálne neepileptické stavy v neurológii
doc. MUDr. Matej Škorvánek, PhD.
Neurol. praxi. 2023;24(4):247 | DOI: 10.36290/neu.2023.060
Paroxysmal dyskinesia
doc. MUDr. Matej Škorvánek, PhD.
Neurol. praxi. 2023;24(4):248-252 | DOI: 10.36290/neu.2023.007
Paroxysmal dyskinesia presents a heterogeneous group of disorders, mostly of genetic origin, but may be also of secondary/symptomatic or functional etiology. In terms of clinical phenotype paroxysmal dyskinesia are classified as kinesigenic, non-kinesigenic, exercise-induced and sleep-related. This review will outline the clinical phenomenology, classification, nomenclature of these disorders and focus will be placed on the differential diagnosis and manifestation of most common disorders presenting with paroxysmal dyskinesia.
Episodic ataxias
MUDr. Ján Necpál, MUDr. Mária Holá, MUDr. Bibiána Jeleňová, MUDr. Marcel Árvai
Neurol. praxi. 2023;24(4):253-257 | DOI: 10.36290/neu.2023.011
Episodic ataxias encompass a group of genetic or acquired conditions with episodic attacks of the cerebellar dysfunction, which may be associated with another various symptoms. Primary episodic ataxias are mainly young-onset. They are characterized by various frequency and duration of the attacks, and variable interictal features and response to acetazolamide (episodic ataxias type 1-9). Acquired episodic ataxias are usually late-onset and manifested by short lasting attacks and other features of underlying condition (multiple sclerosis and others). In this article, we provide a didactive overview and a brief diagnostic algorithm of episodic ataxias...
Alternating hemiplegia of childhood
doc. MUDr. Iva Příhodová, Ph.D., prof. MUDr. Soňa Nevšímalová, DrSc.
Neurol. praxi. 2023;24(4):258-262 | DOI: 10.36290/neu.2023.009
Alternating hemiplegia of childhood (AHC) is a rare genetically transmitted neurological disorder that begins in infancy and presents with a wide range of neurologic symptoms. First manifestations are usually paroxysmal ocular signs and tonic/dystonic attacks. Latter, episodes of transient hemiparesis/hemiplegia on either side of body and quadriplegia develop which are typical for the disorder as well as a relief of symptoms with sleep. Delay in psychomotor development and intellectual disability are apparent and accompanied with extrapyramidal and cerebellar signs. In a half of patients seizures are present. AHC is connected with mutations in the...
Review articles
Improved cognitive function and employment in patients with relapsing multiple sclerosis treated with ocrelizumab
MUDr. Marek Peterka
Neurol. praxi. 2023;24(4):264-267 | DOI: 10.36290/neu.2023.047
Cognitive impairment has a significant impact on the quality of life of MS patients. It leads to impairment in social activities, physical independence, ability to manage daily activities, ability to take regular medication and employment. The aim of modern treatment should not only be to achieve stabilisation of the disease, but also to improve cognitive function and therefore employment. This article presents recent information on the positive effect of ocrelizumab treatment on these parameters.
Post‑stroke epilepsy
MUDr. Eva Zatloukalová
Neurol. praxi. 2023;24(4):268-273 | DOI: 10.36290/neu.2023.056
How should be the post-stroke epilepsy diagnosed? What are the risks of developping this condition after the stroke? And finally, how should we treat this condition and what are the tricky aspects of it? Without this knowledge, it is impossible to treat post-stroke epilepsy effectively. Inappropriate treatment can bring unnecessary patient stigmatization and serious side effects. This review aimes to provide answers to these questions connected to the disease with raising prevalence bringing many risk to the patients.
Diagnosis of multiple sclerosis: can errors and mistakes occur?
doc. MUDr. Zbyšek Pavelek, Ph.D., prof. MUDr. Martin Vališ, Ph.D.
Neurol. praxi. 2023;24(4):274-280 | DOI: 10.36290/neu.2023.010
Multiple sclerosis is a chronic inflammatory demyelinating disease which affect central nervous system. Early diagnosis is the goal due to high activity of imunopathological processes during the begining of this disease Misdiagnosis of multiple sclerosis remains a topical problem in current clinical practice. Studies indicate that misdiagnosed patients are often exposed to prolonged unnecessary health care risks. The clinician needs to be aware of alternative diagnoses, such as functional neurologic disorders, migraine, and vascular disease, along with uncommon inflammatory, infectious, and metabolic disorders that may mimic MS.
Cognitive impairment in chronic migraine
MUDr. Petra Migaľová
Neurol. praxi. 2023;24(4):281-285 | DOI: 10.36290/neu.2023.046
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. Migraine is not only pain, but is also accompanied by other symptoms that complicate the life of patients. Patients with chronic migraine often complain of memory problems and difficulty concentrating. Insufficient concentration and memory can be trained and improved in a targeted manner.
Novel treatment for myasthenia gravis
MUDr. Michaela Týblová, Ph.D.
Neurol. praxi. 2023;24(4):286-292 | DOI: 10.36290/neu.2023.057
Myasthenia gravis (MG) is a rare autoimmune disease characterized by muscle weakness and fatigue. In addition to the currently used non-specifically acting immunomodulating treatment, new specific immunotherapeutics has significantly expanded in recent years. This includes inhibitors of the C5 complement protein, blockers of the neonatal Fc receptor, drugs that cause depletion of B and T lymphocytes and others. The great advantage of all these medicinal products is a faster effect and a significantly lower incidence of side effects. A significant limitation of their use in normal clinical practice may be their expected high price.
From the boundary of neurology
Balance disorders in patients with benign paroxysmal positional vertigo
doc. PhDr. Ondřej Čakrt, Ph.D., doc. MUDr. Jaroslav Jeřábek, CSc.
Neurol. praxi. 2023;24(4):294-298 | DOI: 10.36290/neu.2023.053
Benign paroxysmal positional vertigo (BPPV) is a peripheral vestibular disorder in which otoconia are released from the utricular macula into the semicircular canals. BPPV is the most common disorder of the inner ear in adult and is the cause of vertigo in up to one-fifth of patients presenting to a physician. In patients where there is no history of previous inner ear disease, we refer to BPPV as idiopathic. Often, however, BPPV arises on the terrain of previous labyrinthine disease; we refer to this variant as secondary. Patients most commonly complain of episodes of brief rotational vertigo that occur after a change in head position, typically when...
Current recommendations for the use of MR in multiple sclerosis in clinical practice
prof. MUDr. Manuela Vaněčková, Ph.D., doc. MUDr. Dana Horáková, Ph.D.
Neurol. praxi. 2023;24(4):300-308 | DOI: 10.36290/neu.2023.017
The article presents basic imaging protocols for diagnosis and monitoring in clinical practice. A basic protocol that meets the requirements for the earliest possible diagnosis is presented, therefore, high sensitivity, but it also allows differentiation of other diseases in the differential diagnosis. Additional sequences, which are recommended in specific cases, are briefly mentioned as well. The interval and modification of the protocol in subsequent MRI is when the conditions for diagnosis are not fulfilled. The main change is that the diagnostic protocol includes not only brain but also spinal cord examination. For monitoring in clinical practice,...
Case report
Progressive multifocal leukoencephalopathy as a primary opportunistic infection in a patient with AIDS
MUDr. Martina Miklušová, MUDr. Dalibor Zimek
Neurol. praxi. 2023;24(4):310-313 | DOI: 10.36290/neu.2023.014
Progressive multifocal leukoencephalopathy is a rare demyelinating disorder of the central nervous system, which is found almost entirely in immunocompromised persons - mostly as late complication of HIV infection. We present a case report of rare situation, in which the diagnosis of PML preceded the diagnosis of long-lasting HIV infection. This patient was also the first patient with this diagnosis in Neurology department of The University Hospital Olomouc.
Comments
Komentář k článku: Developing consensus among movement disorder specialists on clinical indicators for identification and management of advanced Parkinson's disease: a multi‑country Delphi‑panel approach
MUDr. Martin Nevrlý, Ph.D.
Neurol. praxi. 2023;24(4):314-315 | DOI: 10.36290/neu.2023.058
Neurologists ask
Jak a kdy je možné použít omezovacích prostředků?
Mgr. Marie Kmecová, Ph.D.
Neurol. praxi. 2023;24(4):316-317 | DOI: 10.36290/neu.2023.059