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Patologie CNS - III

Neurodegenerativn

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Patologie CNS - III

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    1. Patologie CNS - III Nemoci motorickch neuronu

    2. Neurodegenerativn choroby genetick abnormalita modifikovan protein patologick struktury ztrta neuronu

    3. Neurodegenerativn choroby I. Polyglutaminov nemoci (mnohotn Cytosin AdeninGuanin CAG komplexy) m. Huntington II. ? patie, ? synukleinopatie m. Alzheimeri, m. Parkinsoni (Lewyho tel.)

    4. Nemoci motorickch neuronu Axonopatie toxick toxoinfekcn metabolick (polkov!) avitaminosy traumatick sdruen s malignitou

    5. Nemoci motorickch neuronu Neuronopatie Poliomyelitis anterior acuta Poliomyelitis anterior chronica Sclerosis amyotrophica lateralis ALS Paralysis progressiva bulbaris

    6. Nemoci motorickch neuronu 1. spastick spinln paralysa 2. progresivn bulb. paralysa C m. Aran Duchenne T (poliomyelitis ant. chronica) m. Werdnig Hoffmann L myatonia congenita Oppenheim 1. + 2. ALS

    7. Amyotrofick laterln sklerosa Def. nemoc pyramidov drhy z atrofie 1. i 2. neuronu

    8. Amyotrofick laterln sklerosa Klinika zac. mezi 10. 60. rokem obrny spasticko - chab neurogenn atrofie svalu ruky opic ruka bulbrn poruchy smrt behem nekolika let (aspir. bpn.)

    9. Amyotrofick laterln sklerosa Morfologie makro: mikro: atrofie gyrus praecentralis atrofie prednch korenu atrofie svalu (opic ruka) bytek neuronu (GPC, pr. rohy) demyelinizace provazcu atrofie denervacnho typu

    10. Progresivn bulbrn paralysa Klinika porucha fonace, polykn, tachykardie, dunost (z insuf. vagu) Morfologie atrofie neuronu nn. IX, X, XI, XII. vkacch svalu, jazyka Prognosa infaustn

    11. Kazuistika ALS mu 52 let (ridic) *1943 1999 cervenec 1991 fyzick nmaha (jzda na horskm kole) prvn prznaky porucha vslovnosti prechodn , pozdeji trval expresivn afzie polykn centrln hemiparesa dx., pozdeji i sin. progrese v prubehu 4 let smrt bronchopneumoni

    12. Sclerosis amyotrophica lateralis Etiopatogeneze (?) autoimmunn poliovirus (Lansing) defektn interferujc cstice (DIP) VROZEN IMUNOPROFIL & ZSKAN FAKTORY

    13. Hypothesis: A motor neuron toxin produced by a clostridial species residing in gut causes ALS. Longstreth WT Jr, Meschke JS, Davidson SK, Smoot LM, Smoot JC, Koepsell TD. University of Washington, Seattle, Washington, USA. Med Hypotheses. 2005;64(6):1153-1156. A yet-to-be-identified motor neuron toxin produced by a clostridial species causes sporadic amyotrophic lateral sclerosis (ALS) in susceptible individuals. Undetected it resides in the gut and chronically produces a toxin that targets the motor system, like the tetanus and botulinum toxins. Some of the toxin would cross to neighboring cells and to the upper motor neuron and similarly destroy these motor neurons. Weakness would relentlessly progress until not enough motor neurons remained to sustain life. If this hypothesis were correct, treatment with appropriate antibiotics or antitoxins might slow or halt progression of disease, and immunization might prevent disease. a yet-to-be-identified motor neuron toxin produced by a clostridial species causes sporadic amyotrophic lateral sclerosis (ALS) in susceptible individuals. This clostridial species would reside undetected in the gut and chronically produce a toxin that targets the motor system, like the tetanus and botulinum toxins. After gaining access to the lower motor neuron, the toxin would be transported back to the cell body, as occurs with the tetanus toxin, and destroy the lower motor neuron - the essential feature of ALS. Again like the tetanus toxin, some of the toxin would cross to neighboring cells and to the upper motor neuron and similarly destroy these motor neurons. Weakness would relentlessly progress until not enough motor neurons remained to sustain life. If this hypothesis were correct, treatment with appropriate antibiotics or antitoxins might slow or halt progression of disease, and immunization might prevent disease. a yet-to-be-identified motor neuron toxin produced by a clostridial species causes sporadic amyotrophic lateral sclerosis (ALS) in susceptible individuals. This clostridial species would reside undetected in the gut and chronically produce a toxin that targets the motor system, like the tetanus and botulinum toxins. After gaining access to the lower motor neuron, the toxin would be transported back to the cell body, as occurs with the tetanus toxin, and destroy the lower motor neuron - the essential feature of ALS. Again like the tetanus toxin, some of the toxin would cross to neighboring cells and to the upper motor neuron and similarly destroy these motor neurons. Weakness would relentlessly progress until not enough motor neurons remained to sustain life. If this hypothesis were correct, treatment with appropriate antibiotics or antitoxins might slow or halt progression of disease, and immunization might prevent disease.

    14. Neoplasie CNS primrn CNS neoplazie: cca. 2% vech malignit cca 20% malignit u det mladch 15 let sekundrn - metastatick castej ne primrn

    15. CNS neoplasie klin. projevy epilepsie fokln vpady parzy, plegie zv. intrakraniln tlak bolest hlavy zvracen (zejm. u det) zastren vedom, coma edm papily hydrocephalus

    16. Histologick klasifikace tumoru CNS (WHO 2000) 128 ICD-O kdovanch jednotek I. NEUROEPITELOV T. II. NDORY NERVOVCH OBALU NDORY MENING NDORY CVNHO PUVODU PRIMRN MELANOCYTRN LZE LYMFOMY (primrn) 128 kdovanch jednotek128 kdovanch jednotek

    17. WHO Histologick klasifikace tumoru CNS V. GERMINLN TUMORY VI. NDORY SELRN OBLASTI VII. METASTATICK

    18. WHO Histologick klasifikace tumoru CNS I. NEUROEPITELOV NDORY astrocytick oligodendrogliln ependymln, choroidlnho plexu pinealomy neuronln patne diferencovan, embryonln

    19. WHO Histologick klasifikace tumoru CNS II. NDORY NERVOVCH OBALU neurilemmom neurogenn sarkom neurofibrom neurofibrosarkom

    20. WHO Histologick klasifikace tumoru CNS III. TUMORY MENING A SOUVISEJCCH TKN meningeom meningeln sarkom xantomatosn tumory prim. melanom mening melanomatosa

    21. WHO Histologick klasifikace tumoru CNS IV. PRIMRN MALIGN LYMFOMY

    22. WHO Histologick klasifikace tumoru CNS V. GERMINLN TUMORY germinom embryonln karcinom choriokarcinom teratom

    23. WHO Histologick klasifikace tumoru CNS V. GERMINLN TUMORY VI. NDORY SELRN OBLASTI (kraniofaryngeom, ndory hypofzy) VII. METASTATICK NDORY

    24. WHO Histologick klasifikace tumoru CNS VII. TUMORY METASTATICK (zejm. karcinomy a melanom)

    25. Pseudotumory (dif. dg.!) Cysty Rathkeho cysta epidermoidn cysta dermoidn cysta koloidn cysta 3. komory CVN MALFORMACE kapilrn teleangiektazie a. v. malformace nejsou v nov klasifikaci WHOnejsou v nov klasifikaci WHO

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