RS Centrum diagnoses and treats CNS demyelinating diseases, especially multiple sclerosis, whose prevalence in our population is 80-150 people per 100,000 inhabitants. The MS Center cooperates with the Department of Neurology Clinics, which provide diagnostic methods - MRI, Laboratory for Electrophysiology (evoked potentials), and with laboratories investigating cerebrospinal fluid (Institute of Clinical Biochemistry, General Faculty Hospital, Department of Clinical Immunology). more than 3,000 patients from all over the Czech Republic. Over 800 patients are treated with costly first choice drugs, beta interferon and glatiramer acetate and intravenous immunoglobulins. Patients meeting the strict criteria for this treatment are selected by a committee composed of experts from the Czech Neurological Society of CzMA JEP and employees of health insurance companies. Patients not indicated for this treatment according to the criteria of the Czech Neurological Society of the CzMA JEP are treated with combined immunosuppression and clinical and laboratory monitoring as well as patients treated with interferons. Patients with advanced disease are treated with combined or pulsed immunosuppression with cyclophosphamide (Harvard University scheme) or mitoxantrone ( French scheme of Prof. G. Edan). In later stages of the disease, emphasis is placed on symptomatic and rehabilitation therapy. Careful balancing of symptomatic treatment to affect spasticity (including botulinum toxin treatment in debilitating localized spasticities and baclofen pump in mainly lower extremity spasticity in collaboration with the Department of Na Homolce Hospital Neurology), tremor (including sterotactic surgery performed at the Na Homolce Hospital Neurosurgery Department), pain, fatigue , cognitive and psychological problems, etc. is provided for patients at any stage of the disease. All patients have the possibility of undergoing intravenous treatment with methylprednisolone in both acute conditions (if their condition is possible and in close proximity) and in hospital for hospitalization. Neurological Clinic. Patients are instructed to start the treatment as soon as possible with acute symptoms.
Specific problems of patients are solved in cooperation with the following departments of the First Faculty of Medicine:
and extramural workplaces:
|Monday||07:30 - 15:30|
|Tuesday||07:30 - 15:30|
|Wednesday||07:30 - 15:30|
|Thursday||08:30 - 15:30|
|Friday||07:30 - 15:30|
Sleep laboratory instrumentation allows routine night-time polysomnographic recordings as well as daily sleep monitoring (mostly by the multiple sleep latency test). Limited polygraphy is used to investigate sleep disturbances (especially sleep apnea) and various types of continuous overpressure treatment (especially CPAP, BiPAP) for their treatment. The long-term monitoring of locomotor activity (alternating sleep-wake rhythm) is provided by an actigraphic examination. In 2006, the possibility of sleep investigation was increased by another polysomnographic device at the Pediatric Department of the Department of Neurology of the First Faculty of Medicine and General Teaching Hospital. However, in 2011, the Department of Pediatrics of the Clinic terminated its activities and further investigations were carried out in cooperation with the Department of Children and Adolescents 1-LF UK and VFN.
The current research activities of the Center are focused on narcolepsy, restless leg syndrome, pathophysiological connection of sleep breathing disorders, parasomnia and sleep changes from neurological diseases. The Center and its staff collaborate on several international scientific projects on sleep disorders, and the Center has repeatedly addressed grant and research projects of Czech grant agencies and research plans of the Ministry of Education. There is also a clinical evaluation of some drugs in the Center. The Center employees cooperate with other research and academic institutions in the Czech Republic (Academy of Sciences of the Czech Republic, CTU).
Most important indications for examination:
Patients are only ordered on the basis of a recommendation from a treating neurologist or pediatric neurologist, psychiatrist, otorhinolaryngologist or pulmonary physician, or on the basis of their detailed report on sleep disorder. The report is used to assess if the patient is indicated for examination at the Center and to schedule an examination. Recommendations should be sent to: Center for Sleep and Wake Disorders, Department of Neurology, First Faculty of Medicine, Charles University, Kateřinská 30, 120 00 Prague 2.
|Monday||---||14:00 - 18:00|
|Tuesday||08:00 - 12:00||13:00 - 16:00|
|Wednesday||09:00 - 13:00||---|
|Thursday||09:00 - 15:00||---|
|Friday||09:00 - 11:00||12:00 - 14:30|
Myastenia gravis is a disease caused by a disorder of neuromuscular transmission in the neuromuscular disc. It is an autoimmune disease in which most of the affected patients have an increased level of antibodies to the acetylcholine receptor. Both cellular and immune responses against this receptor and the proliferation of autoreactive T cells have been found. Thymus (the thymus), an important immune organ of the anterior interstitial, is thought to be directly involved and is directly responsible for the described autoagression.
In myasthenics, enlargement is often directly attributable to this organ's cancer. Thymomas are found in about 15% of all myasthenia. However, this finding is not a condition for the disease. Thyroid disorder, rheumatoid arthritis, lupus erythematoides or bronchial asthma are a relatively common disease.
The frequency of this disease in the population is about 15 cases per 100,000 inhabitants. The beginning is an inconspicuous, creeping, often disassembled infectious disease. Women are more likely to be affected at a younger age (about 2: 1), and later the rate turns to the detriment of men. The basic manifestation of the disease is muscle weakness and easy fatigue after power output. Weakness may be limited to several muscle groups, particularly ocular (ptosa, diplopia), chewing or swallowing muscles. However, there may be a slight progressive course with other muscle groups, including limb and respiratory muscles. The development of the disease until the myasthenic crisis threatens the patient with respiratory insufficiency and a number of subsequent life-threatening complications. It should be noted here that due to the inconspicuous beginning, the victim's complaints are often downplayed by the doctor and attributed to neurasthenia.
Previously, the prognosis of the disease was very unfavorable. Now, thanks to modern treatment methods, many patients can return to their original occupation and young women often start a family.
Care for patients from all over the Czech Republic is now concentrated in the Center for Diagnosis and Treatment of MG based at the Neurological Clinic of the First Faculty of Medicine and General Teaching Hospital in Prague. The approach to diagnosis and treatment is organized in a multidisciplinary way with the possibility of hospitalization, if necessary in the ICU department. This center was established here in 1991 by the Ministry of Health. It loosely followed the original work of the late MUDr. J. Vejvalka, who worked out a central dispensarisation of patients from all over the Czech Republic suffering from this disease and provided them with regular checks, the availability of medicines, helped by counseling, and concentrated a team of doctors from various fields. In this way, a comprehensive approach to the issue was implemented for the first time, but in-patient facilities that are currently being addressed by the above-mentioned center were missing. The Department of Neurology of the First Faculty of Medicine and the General Teaching Hospital in Prague has more than 40 years of experience with MG treatment.
Diagnosis and treatment of the disease is quite difficult and goes beyond the field of neurology. Therefore, the aforementioned multidisciplinary collaboration with other medical disciplines within the VFN is necessary. Center cooperates with III. Clinic of Gynecology and Obstetrics, Oncology and Immunology Clinic. Significant is the co-operation with the 1st Internal Clinic, which carries out, if necessary, the exchange of plasma in the patient and carries considerable financial costs.
Centralization in one workplace is advantageous, even necessary for the diagnostic and therapeutic demands of a disease whose frequency is not frequent. That is why the center will investigate, eventually, on the recommendation of attending doctors. dispensarisizes patients from all regions of the Czech Republic. Here, by understanding the VFN's headquarters, they are getting everything that the Czech health care industry can offer to the high financial demands of the center.
|Monday||08:00 - 14:30|
|Tuesday||08:00 - 14:30|
|Wednesday||08:00 - 14:30|
|Thursday||08:00 - 14:30|
|Friday||08:00 - 14:30|
Head doctor of the center: as. MUDr. Hana Brozova, Ph.D.
Ordering patients by phone: Monday - Friday, 08:00 - 13:00, tel .: +420 224 965 539
Within the Department of Neurology we use neurological beds, laboratory of clinical neurophysiology (registration of evoked potentials, EMG, EEG) and neuroradiological department (RTG, CT, MR).
|Monday||08:30 - 15:30|
|Tuesday||08:30 - 15:30|
|Wednesday||08:30 - 15:30|
|Thursday||08:30 - 15:30|
|Friday||08:30 - 15:30|