The mutual interaction of epilepsies, epileptic seizures and sleep is multiple. There are seizure types and units of epilepsy classification closely related to sleep and biological rhythms. A number of patients with epilepsy predominantly have seizures in their sleep. Specific interictal epileptic activity and nocturnal seizures alter sleep architecture; frequently, fragmentation of nocturnal sleep occurs. Many sleep disorders, such as obstructive sleep apnoea, provoke and aggravate epileptic seizures. The effect of the antiepileptic medication used is also of significance.

It is estimated that the risk of stroke is increased by 1.5–3 fold for patients with diabetes. Diabetes also doubles the risk of stroke recurrence, and stroke outcomes are significantly worse among patients with diabetes with increased mortality, more residual neurological deficit and longer hospital stays. Diabetes increases the risk of ischaemic stroke more than haemorrhagic stroke. Despite the higher prevalence of stroke in patients with diabetes, they have been shown to be less likely to develop transient ischaemic attack. Tight glycaemic control is recommended to prevent microvascular complications, but its benefits on macrovascular disease and stroke risk are still unproven. The management of patients with diabetes and acute stroke should include multifactorial intervention – antihypertensive, lipid-lowering and antiplatelet agents and, where appropriate, surgical intervention.

Menstrual migraine is a subtype of migraine without aura. Pure menstrual migraine (PMM) which occurs during menstruation, and menstrually-related migraine (MRM) which can also occur outside menstruation are distinguished. In pathophysiology, a decrease in the oestrogen level by the end of the luteal phase of the cycle as well as an increase in prostaglandin within the first 48 hours of menstruation are thought to play the main role. Acute treatment and prophylaxis of MRM do not differ from the routine treatment. Prophylactic treatment of PMM involves intermittent prophylaxis with nonsteroid anti-inflammatory drugs or frovatriptan, hormonal prophylaxis involves the use of steadily high or low levels of oestrogens.

Despite advances in imaging techniques and electrophysiological diagnosis in patients with pharmacoresistant epilepsy, there remain a significant proportion of patients in whom a resection procedure is not feasible or is associated with severe adverse effects. Such patients are potential candidates for stereotactic surgical intervention. The paper reviews the history and current situation of stereotactic lesional interventions used in the treatment of pharmacoresistant epilepsy, their options and results. Stereotactic surgical technique has become the basis of other techniques relevant to epilepsy surgery, namely radiosurgery and neuronavigation.

The goal of palliative care is to provide relief or alleviate symptoms and support the best possible quality of life regardless of the disease status. In paediatric care, it includes the following components: biological, psychosocial, spiritual, treatment plan and practical solutions. The most important part is a mutual communication about the disease as well as options. In addition to the psychosocial aspect, an individual approach is of major importance. The term palliative care has different meanings for the child, parents or carers. Sometimes it means management of pain and symptoms; at other times it is a spiritual aspect, for instance. What is shared, however, is the need to keep some hope even in seemingly hopeless situations. Also related to palliative care are ethical and economic issues.

Primary central nervous system lymphoma (PCNSL) makes 1–2 % of all primary cerebral tumors. In contrast to lymphomas arising from nodal lymphatic tissues, PCNSL affect cerebral tissue. These tumors belong to a variety of non-Hodgkin lymphomas. Their occurrence is especially in immunocompromised patients. PCNSL is in principle good curable with chemotherapy and radiotherapy. The tumor sometimes does not show on follow-up imaging examination after intensive immunosuppressive therapy. Therefore, this tumor is also marked as a vanishing tumor. The diagnosis of PCNSL is verified by the immunohistochemical examinations which certify lymphoid tumor cells. If there are doubts between histological and imaging examination, problems will appear. These problems complicate the course of this disease. We treated a patient with this complicated course of disease in our clinic.

Ultrasound imaging is one of the most available perioperative imaging methods. Ultrasound imaging is based on registering of echo signals reflected by tissue. The basic modality of examination is two-dimensional (2D) imaging in various modes. In neurosurgery, the 2D imaging is succesfully used for intraoperative imaging. Nowadays, the use of ultrasound 3D imaging is spreading in neurological and neurosurgical practice. The three-dimensional imaging alike CT or MRI facititates delineation of pathological lesions. An improvement of perioperative imaging during neurosurgical procedures is expected. First experiences in 3D ultrasound imaging of the glioblastoma resection are presented in this short statement.

This contribution addresses the challenge of chronic non-specific lower back pain (LBP), a matter often accompanied by a degree of unpleasantness for family doctors, vertebrologists, and many other carers. LBP sufferers search various segments of the health care system with considerable energy, sometimes approaching the point of abuse. Most physicians approach this problem through the so-called „biological” model of pain, i. e. by means of imaging and other diagnostic work-up they try to identify the pathological issue leading to the pain and remove it by pharmaceutical and/or surgical means. This classic model has not proved appropriate in chronic non-specific LBP and mirrors one of the causes of unsatisfactory results in more widespread treatment. An increasing number of studies published in recent years recommend the employment of what is known as the operant conditioning model, and present evidence of high efficacy

The article shortly summarizes the associations of intracranial hypertension and its symptoms in the light of its pathophysiological bases. The main symptoms of intracranial hypertension are listed as well as the clinical descriptions mentioned in the past by reputable Czech neurologists.

A 49-year-old female diabetic patient with hypertension presented to a neurological unit with a mild, recurrent central monoparesis of the right arm. Brain imaging failed to demonstrate any pathology. Electrocardiography (ECG) revealed an inferior wall scar. Echocardiography disclosed a left ventricular thrombus; coronarography showed a severe diffuse disease. Cardiac surgery consisting of aortocoronary bypass and thrombectomy was indicated. Cardiac diseases resulting in thrombus formation as well as investigations which are most beneficial in their detection are discussed.

Every neurologist is familiar with usage of osmotically active substances and glucocorticoids in the treatment of intracranial hypertension – these medicaments were introduced into clinical practice more than 50 years ago and the abundant literature supporting their role in this indication is convincing. Bearing this in mind, it is even more interesting that we still don’t know the precise mechanism of their action and there is no consensus regarding the ideal dosage of osmotically active substances, timing of treatment and their effectiveness in different indications. Established treatment algorithms are, however, universally accepted and practiced. We briefly summarize the current state of knowledge and practical approach to the management of intracranial hypertension using the above substances and we also point to certain widely accepted fictions that probably lack any rational background.

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.