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Minimonography describes the algorithm of the assessment and acknowledgment of the new occupational disease: "chronic lumbar spine disorder caused by heavy physical work," focusing on the role of a neurologist in this process. The new item has been added to the List of Occupational Diseases by Government Regulation No. 506/2021 Coll. From January 1st, 2023, the illness can be acknowledged and compensated as an occupational disease. However, the necessary prerequisite is the fulfillment of strict assessment standards, which include both clinical and hygienic criteria. The neurologist plays a partial, but significant role in the assessment whether the criteria have been met. Neurologist does not decide whether it is or it is not an occupational disease. Neurologist´s role is to judge if the patient's disease corresponds to the diagnosis in question, i.e., the chronic lumbar spine disorder having the form of Low Back Pain with and/or without a radicular syndrome. Making the differential diagnosis, neurologist has to rule out other significant causes of the patient's difficulties. Using seven defined parameters of the neurological examination, neurologist rates the severity of the disease and decides whether it reaches the required degree with respect to the patient's age. Only if the neurological criteria are met, the acknowledgment of the occupational disease comes into consideration. This is a necessary condition – but it is still inadequate. [ABSTRACT FROM AUTHOR]

Pri prijetí mel dysartrickou, tichou a srozumitelnou rec, izokorii, bez poruchy okulomotoriky, snízené korneální reflexy, plossí mimiku vlevo, krátce nadzvedl hlavu nad podlozku, jen velmi omezene zvedl patrové oblouky bilaterálne, nesvedl elevaci horních koncetin (HK) nad podlozku, stisk jen naznacen, u DK pouze náznak pohybu v kycelních kloubech, RR C5-8, L2-S2 vyhaslé, s difuzní poruchou cití HK i DK. První zemrel po 6 tydnech a druhy po 3 tydnech po období umelé ventilace s vysazením sedace, kdy kontakt byl mozny pomocí funkcní MR. Byla provedena MR hlavy s následujícími sekvencemi: v axiální rovine T2 vázené obrazy, fluid attenuated inversion recovery (FLAIR), suscetibilne vázené obrazy (susceptibility weighted images; SWI) a difuzí vázené obrazy (diffusion weighted images; DWI); v sagitální rovine T1 vázené obrazy; v koronární rovine FLAIR obrazy. [Extracted from the article]

Various infections can frequently lead to the exacerbation of myasthenia gravis (MG). COVID- 19 infection characterized by lung impairment with respiration failure, massive inflammatory reaction and high mortality may lead to worsening of many neuromuscular disorders including MG. Published series of patients with MG and COVID-19 are considerably variable and diff er in disease severity and selected therapeutic approach. In our group of 11 MG patients, substantial worsening was present in 3 patients, and in 4 there was a mild worsening of clinical myasthenic symptoms. In 3 patients, we used high doses of methylprednisolone intravenously, in 2 patients, the oral doses of prednisone were increased to 40 mg/ 60 mg a day, 1 patient was treated with intravenous immunoglobulin (2 g/ kg), and 1 was treated with remdesivir. An 88-year-old woman was diagnosed with MG after COVID-19 infection. A 77-year-old man died after 6 days of mechanical ventilation. COVID-19 infection leads to an exacerbation of clinical symptoms in a large proportion of MG patients with ventilation disorder due to increased muscle fatigue and inflammatory changes in the lung parenchyma. [ABSTRACT FROM AUTHOR]

Some lesions of the peripheral nerves caused by physical factors can, under certain conditions, be acknowledged as an occupational dis-ease. The decision whether it is an occupational dis-ease or not is authorized by the "Centre of occupational dis-eases". Neurological consultants have a very important role in the process of acknowledgement of an occupational dis-ease. Dur--ing the last 20 years, disorders of neurological character represented 29.6% of all occupational dis-eases. At the same time, the lesions of the peripheral nerves due to overload or vibration constituted 98.5%. Carpal tun-nel syndrome is most frequent, fol-lowed less often by an ulnar nerve lesion in the elbow, and rarely by an ulnar nerve lesion in the wrist and hand –  the Guyon's chan-nel. In the development of occupational compres-sive neuropathies, various mechanisms take place: mechanical pres-sure, hand overload, transmis-sion of vibration on the upper extremity, cold, inappropriate position dur--ing work, and other factors. For acknowledgement of occupational origin of such a lesion, it is es-sential to determine clinical signs and symp-toms, and EMG examination cor-respond--ing to at least the moderately severe lesion. Anamnestic, clinical, and EMG characteristics includ--ing electrophysiological parameters of a moderately severe lesion for the median and ulnar nerves were defined. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manu-script met the ICMJE "uniform requirements" for biomedical papers. [ABSTRACT FROM AUTHOR]

Aim: For uniform assessment of occupational ulnar nerve entrapment at elbow (UNE) assessment methods using electrophysiological criteria were introduced in 2011. The study aimed at determining changes in selected EMG parameters in UNE recognized as occupational disease using the methods in 2012–2016. Patients and methods: In 55 participants (49 males), follow-up EMG at 1 to 5 years from recognition as occupational disease was assessed. Eighty-one arms were affected by UNE. Changes in the amplitude of motor nerve conduction velocity of the ulnar nerve across the elbow (MNCV-U) and in compound muscle action potential over the abductor digiti minimi (CMAP ADM) were compared with initial EMG. Results: The MNCV-U parameter remained unchanged in 54% of cases, deteriorated in 16% and improved in 30%. The mean MNCV-U increased significantly between the measurements. The CMAP ADM amplitude was unchanged in 89% of cases, worse in 4% and better only in 7%. Its mean value at follow-up was not statistically significantly different. There was no case of completely normalized EMG. Conclusion: Occupational UNE is a chronic condition with an unsatisfactory prognosis even after the occupational risk is removed. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE "uniform requirements" for biomedical papers. [ABSTRACT FROM AUTHOR]

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Chronic infl am matory demyelinating polyradiculoneuropathy (CIDP) is a chronic demyelinat ing polyneuropathy with a relaps ing or progres sive course. This is a dysim mune polyneuropathy with activation of humoral and cel lular mechanisms with a primary lesion of myelin sheath in the peripheral nerves. Most frequent is a typical sym metrical polyneuropathy, multifocal neuropathy with a conduction block is less frequent, then distal sym metrical motor and sensory neuropathy, pure sensory or pure motor neuropathies occur rarely. Development of signs and symp toms beyond 2 months is a com mon feature for all variants. Dia gnosis of CIDP is based on clinical fi ndings, precisely developed electrophysiological criteria, and some laboratory fi ndings - hyperproteinor rhachia with normal cell count, and MRI with thicken ing and enhancement of nerves in brachalis and lumbar plexuses or roots. Corticosteroids or intravenous im munoglobulins are used as induction ther apy as the fi rst-line treatment of CIDP. Therapeutic plasma exchange is a second-line ther apy in patients with ineffi cacy or intolerability of the fi rst-line treatment. As adjuvant ther apy, they use azathioprin, mycofenolate mofetil, ciclosporin A, cyclophosphamide, and methotrexate. CIDP is a treatable neuropathy though in some patients it leads to invalidity. [ABSTRACT FROM AUTHOR]

Objective: Martin-Gruber anastomosis (MGA) is a median-to-ulnar nerve communication in the forearm; three types of MGA occur. Typically, motor fi bres course through the median nerve in the upper arm and elbow, however, they supply the ulnar-innervated muscles of the hand: abductor digiti minimi (ADM) - MGA-I; fi rst dorsal interosseous (FDI) - MGA-II; or adductor pollicis - MGA-III. The objective was to determine the prevalence of MGA in a study group of healthy volunteers. Methods: Two hundred and ninety-two healthy participants (457 arms) were enrolled. Motor and sensory nerve conduction studies of the ulnar and median nerves were performed. Ulnar and median nerve compound muscle action potential amplitudes were obtained on stimulation at the elbow and wrist. Results: We found 109 cases of MGA in 90 arms (MGA-I in 30 arms; MGA-II in 57 arms; MGA-III in 22 arms). We found isolated MGA types in 73 arms, a combination of two types in 15 arms, and occasionally (2 arms) a simultaneous combination of all three types. Conclusion: The prevalence of MGA was 19.7%. Most frequently, we found MGA-II (prevalence = 12.5%). Signifi cance: MGA does not produce any clinical signs. However, it can change EMG results. The neurophysiologist must be able to logically interpret such fi ndings. [ABSTRACT FROM AUTHOR]

Copyright of Česká a Slovenská Neurologie a Neurochirurgie is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Ulnar nerve, together with median nerve, innervates the volar group of forearm muscles, hand and fingers. Ulnar nerve is more important for innervation of muscles and weakness, clumsiness of fingers and hand occure in case of the nerve lesion; ulnar claw hand developes in advanced cases. According to the length of the nerve and to the exposed course in regions of elbow and hand, the nerve is frequently overstretched and damaged. The nerve traumatization occurs only rarely in the axilla and arm regions. The ulnar nerve is very often damaged in the elbow, where the nerve is located in a differently deep ulnar nerve grove and then in the cubital tunnel. The ulnar nerve is protected in the forearm course by a layer of fl exor muscles. The nerve appears more superfi cially at the wrist and in the palm, where the ulnar nerve is exposed to chronic traumatization. An ulnar nerve lesion manifests with characteristic weakness of movements and sensitivity disturbances with respect to localization and severity of the lesion. At present, electrodiagnostic methods are the most useful in the diagnostics of the ulnar nerve lesions but neuroimaging (especially ultrasonography) is increasingly more often indicated. Chronic overburden with a damage of the ulnar nerve in the elbow is the second most frequent occupational mononeuropathy. This is why precise methodology for determination of ulnar nerve lesions in the elbow due to occupational cause was developed. Variable approaches are used for surgical treatment of ulnar nerve lesions in the elbow or in the wrist and hand and the surgery is the appropriate and effective therapy in the majority of cases. [ABSTRACT FROM AUTHOR]

The article informs about heart problems in individuals with Emery- -Dreifuss muscular dystrophy are caused by a number of related complications. Topics include Cardiac complications manifest as arrhythmias, atrio-ventricular conduction blockages, congestive heart failure; and Cardiac involvement develops independently of changes in the neuromuscular system as patients should be examined in detail using electrocardiography (ECG), and invasive electrophysiological examination.

Copyright of General Practitioner / Praktický Lékař is the property of Czech Medical Association of JE Purkyne and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of our study was to analyze the results of Adam's forward bend test of asymmetry of paravertebral muscles in primary school children. Our intention was to identify the main parameters of growth and development which can predict the Adam's angle. To reach this goal, we have sampled 270 boys and 270 girls ageing six to fourteen years. These probands were the pupils of primary schools in the Litoměřice region of the Central Bohemia, Czech Republic. The gathered data include Adam's angle, body height, body weight, computed BMI, age and sex. In our sample set, we have found the positive Adam's angle, higher than five degrees, in 27 samples (5,0 %). This number is slightly higher than previously reported data from the Czech children population. By linear regression analysis we have pinpointed the increasing age and body height as the main predictors for positive Adam's angle in our data set. Positive Adam's angle was also found more frequently in girls then in boys, the ratio was 2,4 :1 Body height, body weight and BMI from our data set were compared to these of the 6. National Anthropologica Survey of Children and Youth from 2001. We didn't find the two data sets statistically different. Therefore our data can confirm the fading of secular trend in Czech children. Adam's forward bend test is a fast and straightforward screening method, which can detect scoliotic deformity of the spine. [ABSTRACT FROM AUTHOR]

The authors present two clinical cases of young women with pseudotumor cerebri, which manifested with a tension headache and transient visual disturbance. Normal findings on the neurological examination and the unspecified imaging findings were found in both cases. Optic disc edemas were found in both patients and subsequent lumbar puncture revealed intracranial hypertension. The symptoms and findings on the fundus oculi progressed despite of complex conservative therapy and repeated lumbar puncture. Ventriculoperitoneal shunt was inserted to both patients with improving of visual disturbances and stabilization of condition. [ABSTRACT FROM AUTHOR]

Rapidly progressive movement disorder of the eye bulb associated with pain is a rare clinical presentation, which requires prompt diagnostics and therapy. Painful ophtalmoplegia appears in case of the lesion of cavernous sinus, extraocular muscles or retrobulbar tissue, but could be caused also by the damage of the brainstem. Although modern imaging modalities such as CT, MRI and neurophysiological examination are available, the diagnostic process is not simple. Moreover the prognosis is not often favourable. Both patients admitted at our department, suffering from painful ophtalmoplegia, required complicated diagnostic process, but had favourable outcome, which was a proposal for our publication. [ABSTRACT FROM AUTHOR]

Autoři deklarují, že v souvislosti s předmětem studie nemají žádné komerční zájmy. Redakční rada potvrzuje, že rukopis práce splnil ICMJE kritéria pro publikace zasílané do biomedicínských časopisů. [ABSTRACT FROM AUTHOR]