Memory is one of the most widely studied cognitive domains. In clinical practice, it is of importance to know the basic typesof memory classification and to be familiar with the selection of memory tests. Diagnosing memory disorders requires specificskills that should stem from a good knowledge of memory disorders and of their most frequent causes. The main emphasis inroutine neuropsychological memory testing is placed on administering specific screening or complex memory tests; however,observation and an interview with both the patient and his or her carers also play a significant role.

Functional (psychogenic) movement disorders are characterized variability and inconsistency of the symptoms, which are incongruent with movement disorders known to be caused by organic neurological disease. The pathophysiology of functional movement disorders is still poorly understood. Previously emphasized causal role of psychological factors was questioned and a neurobiological model of the development of functional symptoms has been proposed. The diagnosis of functional movement disorders should rely on the presence of characteristic clinical features and not on exclusion of organic causis. Early diagnosis and its acceptance by the patient, is essential for the prognosis. Therapeutic strategies consist in multimodal approach with a dominant role of the neurologist, who establishes and communicates the diagnosis and guides the treatment.

Diagnosis of multiple sclerosis (MS) requires exclusion of other neurological diseases that can clinically and radiologically mimicMS. Typical features of the first relapse of MS are unilateral optic neuritis, brainstem or cerebellar syndromes, partial spinal lesions.In the presence of atypical signs, red flags, more tests must be done for exclusion of other diseases. With the presentation of threeclinical cases of patients with suspicion of MS, this article shows some diagnoses that can mimic MS. Cases show importance ofcooperation with ophthalmologist. This article also shows importance of early diagnoses of MS for patient's prognoses and hisother therapeutic options.

Chronic pain represents significant society wide society-economy problem. It is participating at a considerable rate to the disabilityof population of developed countries and it has got adverse effect on quality of life. Strategy for chronic pain treatmentis multimodal: it includes pharmacological and rehabilitation treatment, psychotherapy invasive methods and some other treatmentalternatives. Basic treatment strategy is based on WHO three – step analgesic ladder. Basic treatment for chronic pain arenonopiod analgesics,combined in accordance with level of pain with weak or strong opioids. The advantage is that we can useproducts containing tramadol and paracetamol.

Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disorder of the central nervous systeme. It is characterizedby the loss of the homeostatic regulations of the immune systeme comprising both innate and specific T cell mediatedimmunity resulting in the abnormal functional polarisation of T cells into Th17 and Th1 subsets together with the participation ofabnormal B cells. Drugs used in clinical practice are targeting different steps of the inflammatory immunopathological process.The effect of this treatment could be enhanced by the optimal life style of MS patients. The inflammation in MS patients couldbe simply targeted by optimal nutrition. The special emphasize should be paid to the optimalisation of the gut microbiota. Thenutrition should be enriched for all components modulating inflammation in MS patients. These comprise vitamine D, vitamineB, vitamine C, polyunsaturated fatty acids, prebiotics, probiotics and the substances of herbal origin, especially polyphenols.

diseases associated with disorders of iron metabolism Iron plays a significant role in the human body. Neurodegeneration with brain iron accumulation (NBIA) characterizes a heterogeneous group of neurodegenerative diseases associated with iron accumulation in the central areas of the brain. The most common disease of this group is pantothenate kinase-associated neurodegeneration (PKAN), an autosomal recessive disease characterized by a mutation in the PANK2 gene and impaired metabolism of coenzyme A. Also included here are phospholipase A2-associated neurodegeneration caused by a mutation in the PLA2G6 gene and conditions, such as neuroferritinopathy, aceruloplasminaemia, and others, that currently belong to the NBIA group. Iron metabolism is also linked to other systemic conditions, e.g. haemochromatosis. The paper presents the characteristic features, clinical manifestations as well as the options for diagnosis and differential diagnosis of these conditions. aceruloplasminaemia, haemochromatosis.

Vestibular rehabilitation is a set of exercises that accelerate the process of vestibular compensation and allowing adaptation to existing vestibular pathology. These techniques utilize CNS neuroplasticity, leading to a recalibration of the sensory system. In order for rehabilitation to be successful, an individual rehabilitation plan has to be devised with respect to the test results of examinations, symptoms and patient´s present complaints.

Vaccination is a topic which is being more and more discussed in recent years. As with every effective medicament, the use of vaccines can also lead to side effects which are more or less reversible, affecting mainly children vaccinated during infancy due to their vulnerability. Serious adverse events such as neurological complications are fortunately rare. The following article presents a listing of complications and focuses on vaccines available in Czech Republic at the time.

Another drug for relapsing-remitting multiple sclerosis (MS) has been introduced into the market in recent months. It is the socalled“PEGylated” interferon beta-1a. It is the original interferon beta-1a molecule, which has been known in the treatment of MSfor two decades, but has newly been bound to a molecule of polyethylene glycol (PEG), which provides it with some propertiesimproving the overall profile of the original interferon molecule. The article summarizes the profile of efficacy on clinical andradiological parameters and the safety profile of the drug established by the pivotal clinical trial ADVANCE as well as by its extensionstudy, called ATTAIN. PEGylated interferon beta-1a has now expanded the portfolio of first-line disease-modifying drugs(DMDs) used in the treatment of clinically isolated syndrome or relapsing-remitting MS.

The role of B cells in the inflammatory response is much wider as previously thought. B cells are not only antibodies producingcells but are the rich source of various proinflammatory cytokines and chemokines. B cells can identify various signals of dangeror damage. These danger molecules are processed and presented in the form of antigenic peptides in the context of HLA moleculesto T cells. Suprisingly, biological therapy with ocrelizumab targeting CD20 molecule expressed on B cells was evidencedas highly effective therapy of multiple sclerosis in large clinical trials. There are the substantial differencies in the structure andposttranslational modification comparing different antiCD20 monoclonal antibodies. These differences are responsible for bothimmediate and longterm adverse effects of this type of biological therapy in the treatment of multiple sclerosis.

Aim: To highlight the need for early diagnosis of inflammatory rheumatic causes of back pain that, due to their rare occurrence,tend to be overlooked easily in patients with back pain.Summary: The group of inflammatory rheumatic diseases of the back (spondyloarthritides /SpA/) include autoimmune inflammatorydiseases wherein the inflammation affects the axial skeleton, root joints, and peripheral joints, predominantly in the lowerlimbs. The most common disease of the SpA group is ankylosing spondylitis (Bechterew’s disease). The diagnosis of ankylosingspondylitis has been based on the 1984 modified New York criteria which require radiographic confirmation of injury to thesacroiliac joints. The author aims to highlight in the article that the use of novel diagnostic methods has fundamentally changedthe approach to this disease, and presents an overview of the current classification criteria that allow for detection of the diseaseprior to developing permanent structural changes.Conclusion: Early diagnosis allows for a rapid commencement of adequate treatment that can significantly affect the furthercourse of the disease.

Surgical treatment of epilepsy represents an important therapeutic option in patients with drug-resistant epilepsy. At Departmentof Paediatric Neurology, Motol Epilepsy Center, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospitalpaediatric epilepsy surgery has been practiced since 2000. Up to 1st November 2017 263 surgeries in 232 patients have beenperformed. This article aims to summarize essential principles both epilepsy surgery and preoperative diagnostic work-up as wellas results of our paediatric epilepsy surgery programme including recent trends. 80,7 % children in our series are seizure-free at 2year follow-up. Candidates undergoing early surgery have better chance gaining both seizure and AED freedom and (in children)their cognitive potential is more likely to be preserved.

Introduction: Painful diabetic polyneuropathy (PDPN) is a frequent complication of diabetes; however, its severity is usuallyunderestimated and it is often not managed adequately. The aim of the study was to evaluate whether patients with PDPN werereceiving treatment for neuropathic pain and what the treatment response was.Methods: This is a retrospective evaluation of baseline data obtained from an observational, cross-sectional, multicentre cohortstudy. The study included 232 patients with diabetic polyneuropathy associated with type 1 or type 2 diabetes (92 women, medianage 63 years, age range 21–87 years). The occurrence of PDPN was determined and treatment of neuropathic pain was analysed. Patientswith pain were divided into the following subgroups: untreated (naive), responders to treatment, non-responders to treatment.Results: The study cohort included 157 (67.7 %) PDPN patients, with 127 patients (54.7 %) reporting moderate to severe pain(NRS ≥ 4). In the group of PDPN patients with NRS ≥ 4, sixty-nine (54.3 %) were receiving treatment for neuropathic pain and 58(45.7 %) patients were untreated. There were 39 responders to treatment (56.5 %) and 30 non-responders to treatment (43.5 %).Monotherapy was the preferred type of treatment for PDPN (76.2 % of patients), with gabapentin (54 % of patients) and pregabalin(20.6 % of patients) being the most commonly used agents.Conclusion: The treatment for PDPN was not satisfactory (46 % of patients with moderate to severe pain failed to receive treatmentfor neuropathic pain; poor response to treatment for neuropathic pain was shown in 44 % of patients). The predominanttype of treatment for neuropathic pain was monotherapy, with gabapentin and pregabalin being the most commonly used agents.

Pain is subjective perception a and the effective management of chronic pain is fundamental goal for the people , who treat thepain. Chronic pain is describe like two basic kinds of pain – nociceptive and neuropathic pain., wich appears separatly or in combination.The World Health Organisation (WHO) developer outlines the tree-step analgesic lader these opioids in the managementof cancer pain, and these are widely accepted and extensively validated guidelines heve been influential in the aplplication ofopioidy therapy for treatment of chronic, non-malignant pain.The morfin is the main representative such potent opioids and plays an important role in management of pain in patients withchronic pain in paliative care. The newer- generation agents –fentanyl, buprenorfin, oxycodon, hydromorfon and tapentadolplays important role in chronic, non malignant pan.New opioid tapentadol is the first compoud of new pharmacological class MOR-NRI, that combines mi-opioid-agonist and noradrenalinre-uptake inhibitor activities in one molecule.

Based on controlled studies valproate, carbamazepine and lamotrigine have a firm position in the treatment of bipolar disorder. Besides lithium they are considered to be the most important representatives of mood stabilizers (MS). According to available guidelines MS are recommended in all phases of bipolar disorder. The aim of this retrospective study was to assess the treatment of bipolar disorder in clinical practice. Analyzing charts of patients we found that totally 71 patients (37 female, 34 male) were hospitalized 92 times (35 with mania, 53 with depression) during the 2-year period. In both mania and depression the most frequently used treatment strategy was the combination of MS and atypical antipsychotic. This is corresponding with the data about a more robust effect of combination in severe disorders requiring hospitalization. The most frequently used MS was valproate, the most frequently used antipsychotics were olanzapine and quetiapine. However, with long-term treatment the issue of side effects has to be considered (weight increase, teratogenity).

Neurophysiological methods are less and less significant contributing to diagnosis of spinal cord lesions in the period of continuoustechnical improvement of imaging methods such as magnetic resonance, PET/CT, etc. However, their benefit remains in diagnosis,prognosis, evidence of subclinical dysfunction, or clear evidence of a spinal cord lesion that is not apparent on morphologicalmethods. These morphological methods (magnetic resonance imaging, CT, x-ray) reliably determine anatomical proportions inthe spinal canal, including structures that are located near the spinal cord and spinal roots. A correlation between morphologicaland functional methods is required, based on a detailed history and objective clinical finding. Electrophysiological methods canbe used to determine dysfunction at the level of the spinal segment, spinal reflex arc, motoneuron or spinal pathways. In thisstudy we present an overview of neurophysiological methods used in the diagnosis of spinal dysfunctions (somatosensory andmotor evoked potentials, H reflex and F wave, cutaneous silent period).

Botulinumtoxin is one of the most poisonous neurotoxin produced by the bacterium Clostridium botulinum. This paper deals with the basic mechanism of action in the context of its potential for therapeutic use in muscle spasticity and other disorders. Since today there are several medicines containing botulinumtoxin, in the text, among others, their mutual differences have been addressed. These play an important role for different immunogenicity profiles.

Multiple sclerosis is a chronic inflammatory demyelinating disease which affect central nervous system. Early treatment is thegoal due to high activity of imunopathological processes during the begining of this disease. If a treatment effect is insufficient ormissing then escalation therapy is indicated. Optimizing treatment in MS earlier may prevent accumulation of irreversible damage.

Epileptic seizures are defined as a transient occurrence of symptoms due to abnormal disinhibited or extremely synchronisedcortical activity. When they occurr in isolation, they can be provoked by different processes influencing brain cortex. However,repeated epileptic seizures signalise irreversible microscopic or macroscopic damage of the brain cortex. Intensity of inflammatoryprocess in the brain cortex and intensity of post-inflammatory changes correlate with epileptic seizures and epilepsy in multiplesclerosis. In this article we are dealing with current information about epilepsy and multiple sclerosis.

Technical gasoline is a mixture of aliphatic and aromatic carbohydrates that is used for cleaning the metal products and components. It enters the human body by inhalation, less often through gastrointestinal and transdermal way. In 55-year old man a chronic intoxication of technical gasoline vapors developed during 10-month exposure. At first some unspecified symptoms occured (headaches, disturbances of concentration), then dyspnea with epigastric pain (he was shortly admitted to department of internal medicine), and lastly as an acute psychotic state (hospitalization in psychiatry). Since then there are outlasting psychiatric symptoms (anxiety, disturbances of thinking, cognitive deficit), neurological signs (extrapyramidal syndrome, tremor), and pathological findings of auxiliary investigations (EEG, VEP, EMG, MRI). An occupational disease was acknowledged.

Spinal muscular atrophy is a group of hereditary disorders caused by degeneration of alpha motor neurons in anterior horn cells. Clinically, they show as progressive, mostly as proximal muscle weakness. Although 95 % of cases are autosomal recessive forms caused by mutations in SMN1 gene, it is a heterogeneous group of disorders. Due to incidence 1: 6 000–10 000, they are rare diseases. As for prevalence, the number of SMA patients in the Czech Republic ranges in hundreds. At present, the care for SMA patients is predominantly covered by paediatric neurologists. Thanks to better symptomatic care, the survival of most SMA patients prolongs to adulthood, including the most severe SMA forms. Causal therapy has not been possible to date; the hopes for future are the ongoing clinical trials with experimental therapy, especially the methods modifying splicing or gene therapy.

Although a routine scoring of patients is not very popular, it can not be overlooked because it provides us a natural course of thedisease, efficacy of treatment and comparison of patients. There are specific attributes of myasthenia outcome measures due toa fluctuating nature of myasthenia. The aim of this article is a review of commonly used myasthenia scales with an emphasis onpractical implementation.

Multiple sclerosis (MS) is the most common autoimmune disorder affecting the central nervous system. It is the most commoncause of neurologic disability in young and middle-aged adults also. To minimize the clinical burden associated with MS, earlycontrol of CNS disease activity is a treatment priority. Dimethyl fumarate (DMF) and fingolimod are important drugs in the arsenalfor treating relaps/remitent type of MS. This article is concerned with the DMF and fingolimod in clinical trials and clinical practice.

The efficacy of multiple sclerosis therapy by monoclonal anti- CD 20 antibodies was confirmed in clinical trials. Three monoclonalantibodies ocrelizumab, rituximab and ofatumumab are effective. The efficacy of ocrelizumab was shown in relaps-remitting andprimary progressive course of multiple sclerosis and broadens the spectrum of multiple sclerosis therapy. In primary progressivecourse of multiple sclerosis ocrelizumab is the only effective therapy until now.

The aim of this article is to give the insight to the field of robot assisted rehabilitation in patiens with post stroke upper limbparesis. The article provides the reader with basic classification of robotic devices and summarizes actual scientific evidence andthe perspective of their use in the future.