Bladder atonia and areflexia are functional consequences of spinal shock following SCI. Sphincters are inactive, voiding is not possible. The bladder is distended. During this acute phase the therapeutic aim occurs in ensuring of the urine derivation preventing complications. Following procedures are used: permanent indwelling catheter, suprapubic drainage, intermittent cathe terization, reflex voiding by bladder tapping and suprapubic manual pressure. First days after injury on the ICU, a permanent indwelling catheter is used, later on changed to suprapubic drainage. It is recommended to change to intermittent catheterization as early as possible. Related to the level of injury the catheterization by themselves is trained for. Presence of urine infection can influence these algorithms. An adequate therapy of urine infection prevents bladder stone formation. Basic diagnostic for detrusor-sphincter dyssynergy during the chronically phase is the video-urodynamical assessment. Therapy is difficult, it occurs in a sufficient derivation. Pharmacological therapy mainly is focused to reduce the hydrostatic pressure in the urine system. Beside suprapubic epicystostomy surgical procedures are described. Those procedures support continence or provide for permanent incontinence (urinal).

Epileptic as well as non-epileptic seizures are frequent problem in teenage. Both intrinsic (e. g. estrogens/gestagens rate) and exogenic (e. g. sleep deprivation and first experiences with alcohol). Psychosocial and neurovegetative instability should be causative factor of high incidence of non-epileptic or migrenous attacks.

The complexity of the topographic relations of the spine, spinal cord, and spinal nerves is a result of the incongruous growth of the spine and the spinal cord, the growth of which is retarded from the third month of embryonic development. The spinal cord only extends to the upper portion of the lumbar spine and the spinal nerves run obliquely down the spinal canal. Those spinal cord segments that were originally situated at the level of the corresponding vertebrae are located above the vertebral bodies. From the level of the second lumbar vertebra down the spinal canal, only spinal roots are found resembling a horse's tail (cauda equina) in appearance. In contrast to the intracranium, the morphology of the epidural space and of venous drainage is different.

Peripheral neuropathies represent various disturbances of peripheral nervous system and according to localization of peripheral nervous system lesions (neurons, roots, ganglia, nerves), distribution and extend of lesions (mononeuropathies to polyneuropathies), type of lesion (axonal, demyelinisation, mixed), and clinical course (acute, chronic, remitting, steadily progressive) are differing one from another. Patients with peripheral neuropathies are often coming to neurological outpatients’ clinics. A successful diagnosis and a satisfying therapy use to be a difficult problem. An overview of basic aspects of neuropathies with suggestion of logical diagnostic process and principles of therapy should contribute to further proceedings in care of these patients.

Choreatic dyskinesias are caused by the hetegenous dysfunctions of basal ganglia system. For clinical settings we have several options: antipsychotics (i. e. risperidone, tiapride), presynaptic dopamine depletors (tetrabenazine), GABAergics (clonazepam), antiglutamatergics (i. e. amantadine). Their intensity could be pharmacologically controlled, at least partially, however their causal curability is only seldom available.

Pompe disease (PD, type 2 glycogenosis, GSD II, acid maltase deficiency) is a progressive genetic disorder caused by the deficiency of lysosomal enzyme with the glycogen accumulation particularly in the skeletal and cardiac muscles. Its incidence is 1:40 000 births and occurs both in childhood and adult age. The disease prognosis is unfavourable, even catastrophic in an infantile form, but its course can be relieved and the patients´ as well as their families´ life quality improved thanks to enzyme replacement therapy (ERT). In the Czech Republic there was initiated last year a project of examining a risk group of patients with PD by screening investigations of blood using the „dried blood spot“ (DBS) method. If the results is positive, the diagnosis will be either confirmed or disproved by means of examining the activity of acid alpha-1.4-glucosidase (GAA) in leukocytes and mutation analysis on the DNA level. The project principal aim is to reveal still not diagnosed PD patients and to improve the knowledge of professional population about clinical manifestations and prognosis of this disorder. Another goal is to find out the PD incidence in the Czech population as well as diagnoses and problems under which the patients have been registered. Positive patients for whom the ERT is suitable will be then treated correctly and early. The examination by means of „dried blood spot“ is a simple and not burdening investigation, and the registration of patients is supposed to be realized by 2010.

The stimulation technique in neurosurgery is based on the possibilities of sterotactic technique, technical parameters of implantable systems, imaging techniques, and contemporary pathophysiological and clinical knowledge on the role of the potential targets of electrical stimulation. It is the case of not only the stimulation of subcortical structures, but also of those of the cerebellum and cerebral cortex. An advantage of stimulation therapy is the reversible nature of electrical stimulation, limitations include economic factors and mechanical complications of implantable systems. The development of responsive systems which respond to recorded epileptic discharges offers a promising perspective.