Slovo úvodem

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

Neurol. praxi. 2024;25(5):335

Úvod k hlavnímu tématu Neurokardiologie

prof. MUDr. Ivana Štětkářová, CSc., MHA - editorka hlavního tématu

Neurol. praxi. 2024;25(5):341

Hypertension and neurological diseases

MUDr. Petr Mikulenka, prof. MUDr. Ivana Štětkářová, CSc., MBA

Neurol. praxi. 2024;25(5):342-346 | DOI: 10.36290/neu.2024.030

Hypertension, defined as an increase in blood pressure above 140/90 mmHg, is associa­ted with damage to a number of organs, including the brain. Clinical manifestations include hypertensive encephalopathy, posterior reversible encephalopathy syndrome, and cerebrovascular accidents. Chronic hypertension contributes to structural and functional changes in brain tissue, which can lead to clinically manifest impairment of cognitive functions and the development of dementia. The pathophysiological basis of brain damage induced by hypertension is complex. Early detection of hypertension and its adequate treatment are crucial for reducing the risk of neurological...

Takotsubo syndrome and central nervous system

prof. MUDr. Petr Toušek, Ph.D., MUDr. Karolína Poledníková

Neurol. praxi. 2024;25(5):348-350 | DOI: 10.36290/neu.2024.007

Takotsubo syndrome is defined as a syndrome of acute heart failure that is very often manifested clinically as acute coronary syndrome. Transient left ventricular dysfunction is a characteristic clinical feature. Acute neurological diseases are relatively frequently the triggering factors; thus, it is assumed that it is the central nervous system that plays a significant role in the pathophysiology. The review article aims to provide basic information on Takotsubo syndrome with a focus on the very likely pathophysiological mechanisms in the brain-heart axis.

Severity of cardiac involvement in Emery­‑Dreifuss muscular dystrophy

doc. MUDr. Edvard Ehler, CSc., prof. MUDr. Ivana Štětkářová, CSc., MHA, doc. MUDr. Ing. Karol Čurila, Ph.D.

Neurol. praxi. 2024;25(5):353-356 | DOI: 10.36290/neu.2024.033

Emery-Dreifuss muscular dystrophy (EDMD) belongs to a rare genetic diseases with disturbances of the genes encoding nuclear membrane proteins. Neurological symptoms are less pronounced and not too limiting for EDMD patients; however, dominant cardiac symptoms with conduction impairment (AV block, atrial arrhythmias) and/or cardiomyopathy are the most serious manifestations of EDMD. We present 10 patients with EDMD, pointing out the variability and severity of cardiac problems, including long-term medical care within the approach of the multidisciplinary medical team.

Cardiovascular adverse effects of neurological and psychiatric drugs

MUDr. Václav Boček, Ph.D., PharmDr. Kristina Pechandová, Ph.D.

Neurol. praxi. 2024;25(5):357-361 | DOI: 10.36290/neu.2024.015

With increasing pharmacotherapeutic options, the spectrum of adverse effects and drug interactions of individual drugs used in neurology is expanding. Cardiovascular adverse effects and drug interactions are among the frequent and potentially life-threatening conditions that can be prevented by correctly indicating individual medicinal products. The present review article focuses on providing an account of basic drug-induced complications, such as arterial hypertension, orthostatic hypotension, cardiac conduction disorders, myocardial ischaemia, and cardiomyopathy. It also deals, to a lesser extent, with interactions of neurological drugs with cardiological...

Complement inhibitors eculizumab and ravulizumab in the treatment of generalized myasthenia gravis (gMG)

MUDr. Ivan Martinka, PhD.

Neurol. praxi. 2024;25(5):362-366 | DOI: 10.36290/neu.2024.047

The current conventional treatment of generalized myasthenia gravis (gMG) has various pitfalls - later onset of effect of some drugs, occurrence of adverse effects limiting the treatment itself and the patient's quality of life, lack of effectiveness in a small group of patients. Therefore, new drugs are being developed that specifically affect parts of the immune system that are in a clear causal connection with the MG etiopathogenesis. The advantage of these drugs is their high efficiency and good safety profile. Complement inhibitors, which are used in the etiopathogenesis of MG with positivity of antibodies against the acetylcholine receptor (AChR),...

Treatment of Dravet syndrome

MUDr. Katalin Štěrbová, prof. MUDr. Pavel Kršek, Ph.D.

Neurol. praxi. 2024;25(5):368-372 | DOI: 10.36290/neu.2024.048

Dravet syndrome is a developmental and epileptic encephalopathy starting in infancy and its main features are drug -resistant epilepsy and several co-morbidities. Seizures are typically provoked by increased temperature. The treatment of Dravet syndrome is challenging. The first antiseizure drug should be valproic acid, while clobazam, stiripentol, fenfluramine, canabidiol or topiramate are usually added later. All the patients must have rescue medication for home management of seizures. Sodium channel blockers should not be used for chronic treatment, but phenytoin can be administered to stop status epilepticus. Non-pharmacological treatment of co-morbidities...

Surgical treatment of spontaneous intracranial hypotension

MUDr. Václav Vybíhal, Ph.D., MUDr. Martin Plevko, doc. MUDr. Miloš Keřkovský, Ph.D., MUDr. Tereza Janáčková, MUDr. Hana Pikulová, doc. MUDr. Pavel Fadrus, Ph.D., prof. MUDr. Martin Smrčka, Ph.D., MBA

Neurol. praxi. 2024;25(5):373-378 | DOI: 10.36290/neu.2024.004

Spontaneous intracranial hypotension is characterized by postural headaches arising from leakage of cerebrospinal fluid without any previous insult into the extradural space. Magnetic resonance is of fundamental importance in the diagnosis of the disease due to a number of typical signs occurring in this disease in the vast majority of patients. The second step is the identification of the location of the cerebrospinal fluid leak, which requires special diagnostic imaging methods and examination techniques. Spontaneous intracranial hypotension can also disappear spontaneously. Its treatment is primarily conservative and consists of rest, volume therapy...

Physiotherapy in patients with multiple sclerosis with more severe neurological deficit

Mgr. Klára Novotná, Ph.D., Bc. Veronika Knapová, MUDr. Ingrid Menkyová, Ph.D., prof. MUDr. Eva Kubala Havrdová, DrSc.

Neurol. praxi. 2024;25(5):379-382 | DOI: 10.36290/neu.2023.076

The article presents the possibilities of rehabilitation care (specifically physiotherapy) for people with multiple sclerosis with severe neurological deficit (EDSS ≥ 7.0). Theoretical findings are illustrated with data from our pilot study of home physiotherapy in 4 patients.

Spinal endoscopy - treatment of the lumbar disc herniation

MUDr. Peter Hudák, MUDr. Jakub Šipoš, MUDr. Kristián Varga, MUDr. Ján Kozák, PhD., MUDr. Martin Sedliak, MUDr. Benedikt Trnovec, MUDr. Milan Liška, PhD., MPH

Neurol. praxi. 2024;25(5):383-388 | DOI: 10.36290/neu.2023.062

From the works published so far, the endoscopic spine surgery of the lumbar spine has its justification. Miniinvasive approach spares muscles, minimizes postoperative pain, shortens hospitalization and of course recovery. It proves the results of our patients after disc herniation treated by endoscopic surgery. In patients we register less postoperative pain, less consumption of analgesics postoperatively, early verticalization and early return to everyday activities. We evaluate the endoscopic discectomy (interlaminar and transforaminal) as an efficient surgical method in treatment of lumbar disc herniation in cases such as radiculopathy, hyperalgic...

The initial results and our experiences from the OCARINA II study indicate that the subcutaneous form of ocrelizumab is comparable in efficacy to the intravenous form

MUDr. Michal Dufek, Ph.D.

Neurol. praxi. 2024;25(5):389-391 | DOI: 10.36290/neu.2024.064

Ocrelizumab is the first monoclonal antibody targeting the CD20 surface marker found on a subpopulation of B lymphocytes, which has been approved for the treatment of multiple sclerosis. Until now, this treatment was only available as an intravenous form with a relatively long administration time, albeit with high efficacy. As of July this year, its subcutaneous form has been approved based on the OCARINA II study, in which our center also participated. In this brief report, we summarize the basic achieved results from the study as well as our own experiences with this treatment, whose subcutaneous form has the potential to ease the burden on our patients...

Tuberculoma or tuberculous abscess? - two case studies

MUDr. Šárka Herrmannová, prof. MUDr. Radoslav Matěj, Ph.D., MUDr. Adam Pavličko, MUDr. Ondřej Sobek, CSc., doc. MUDr. Dušan Pícha, CSc., MUDr. Michaela May, Ph.D., prof. MUDr. Robert Rusina, Ph.D.

Neurol. praxi. 2024;25(5):393-398 | DOI: 10.36290/neu.2023.013

Brain tuberculomas and tuberculous abscesses are rare focal manifestations of central nervous system tuberculosis. Their clinical and morphological presentation may mimic brain tumors or bacterial abscesses, and therefore be a source of diagnostic ambiguity. The goal of our presentation is to demonstrate two case reports of patients with a solitary lesion of tuberculous origin, and related diagnostic pitfalls. Despite the decrease in tuberculosis incidence in the Czech Republic, it is obvious that physicians may continue to encounter patients with immunosuppressive therapy and migrants from endemic regions. Regarding their relatively favorable therapeutic...

Progressive supranuclear palsy and Guam parkinsonian complex or a Canadian in the Pacific - John C. Steele (1934-2022)"

prof. MUDr. Petr Kaňovský, CSc., FEAN, prof. MUDr. Kateřina Menšíková, Ph.D., MBA, FEAN, prof. Ing. Miroslav Strnad, CSc., DSc., RNDr. Alena Vydrová, Mgr. Pavla Dubská, Ph.D.

Neurol. praxi. 2024;25(5):406-413 | DOI: 10.36290/neu.2024.051

John Charles Steele (1934-2022) was a Canadian neurologist who, together with Richardson and Olszewski, described a new nosological entity that was originally named epony­mously; however, over time, it became known as progressive supranuclear palsy. Later, he was concerned with epidemiological and clinical research on the endemic disease of amyotrophic lateral sclerosis-parkinsonism-dementia complex of Guam, documenting its occurrence, phenotypes, clinical manifestations, heredity, and decreasing incidence as well as prevalence. He also studied the pathophysiology of this disease, for years holding the view that it was a hereditary polygenic disease;...

Stereotypies

MUDr. Kristýna Dolečková, prof. MUDr. Jan Roth, CSc.

Neurol. praxi. 2024;25(5):400-404 | DOI: 10.36290/neu.2023.044

Stereotypies are repetitive, rhythmic, seemingly purposeless movement patterns. Primary stereotypies are typically described in healthy children with normal development, stereotypies with a trigger in adulthood are significantly rarer. The prevalence of primary stereotypies is reported between 3 and 8 %. Secondary stereotypies appear either as a result of sensory deprivation, social isolation or as part of broader syndroms in many, especially neurodevelopmental diseases, in psychiatric diseases or drug-induced syndromes. In the genesis of stereotypies, both neurobiological mechanisms, including genetic disposition, and the effects of the external environment...