Ambulance of the Regional Spasticity Centre of Hořovice Hospital - AKESO POLICLINIC
Examination and treatment of patients with spasticity of the limbs (e.g. after stroke, cerebral palsy, in patients with multiple sclerosis...) is carried out in cooperation with the Rehabilitation Hospital Beroun.
The quality of care is ensured by the cooperation of an erudite neurologist (botulinum toxin applicator with a ČNS certified neurosonology course, functional expertise for electromyography), rehabilitation doctor, physiotherapist, speech therapist.
Injection of botulinum toxin into the affected muscles under USG (ev. EMG) control is also carried out in focal dystonia (involuntary muscle spasms and contractions causing abnormal movements or positions of body parts) especially cervical (cervical muscle involvement with twisting, bowing, head tremor), blepharospasm (clenching of the eyelids), graphospasm (spasm of the hand when writing), hemifacial spasm (uncontrollable twitching of the muscles of one side of the face) or to the salivary glands to relieve the accumulation and leakage of saliva due to neurological disorders.
The effect of botulinum toxin therapy lasts 2 to 4 months, and injections are repeated after the effect has subsided.
EMG (Electromyography)
An electrophysiological method used to determine the functional status (diagnosis of impairment) of motor nerve cells in the spinal cord (e.g. ALS), some nerve roots, peripheral nerves (often carpal tunnel syndrome or polyneuropathy of the lower limbs), neuromuscular transmission (especially dg. myasthenia gravis - MG), muscles (dg. myopathy) or demonstration of increased neuromuscular excitability (tetany).
It includes various methods of stimulation and registration of activity in the peripheral nervous system and muscle, such as neurography (examining the conduction velocity and some other parameters of peripheral nerve fibres with superficial skin electrodes), repetitive stimulation (in MG examinations, repeatedly 8-10 stimuli at a low frequency of 2-3 Hz) and needle EMG (an invasive technique using a thin needle electrode inserted through the skin into the muscle).
The examination, which is performed on the recommendation of a general practitioner, neurologist or other specialist (e.g. diabetologist, orthopaedic surgeon), is tolerated by the vast majority of patients without difficulty, but in some cases may be perceived as mildly uncomfortable.
There is no special preparation, the limbs should be clean, free of locally applied cosmetic or medical products and accessible. Cholinesterase inhibitors (drugs used in the treatment of MG) are not used 24 hours before the examination with repetitive stimulation.
Education:
- Medical Faculty of Charles University in Pilsen (graduation 1999)
- Certification in neurology, 1st degree (2002)
- Specialized medical competence in neurology (2005)
- Functional expertise in electromyography (examination passed on 15 May 2019)
- Diagnosis and therapy of spastic paresis (neurosonology course for botulinum toxin applicators upper and lower limb) - certificate ČNS-UZ012 (30 January 2023)
Past medical practice
- Neurological Clinic of the University Hospital Pilsen (1 October 2007 - 31 December 2024; 5 years as head of the department) - preventive, diagnostic and therapeutic care in the field of neurology, including consiliary examinations, education and training of physicians, work in a specialized outpatient clinic for dystonia with botulinum toxin application, EMG examinations
- Neurological outpatient clinic and EMG laboratory of the Railway Polyclinic Plzeň (1 April 2004 - 30 September 2007)
- Neurological Consiliary of Mulac's Hospital in Pilsen (2006 - 2007)
- Neurological Department of the Medical University of Pilsen (1 February 2000 - 31 March 2004)
- Garrison infirmary of VU Zbiroh (1 November 1999 - 31 December 1999)
Courses and internships within IPVZ
- Electromyography (3 October - 16 November 2005, Faculty Thomayer Hospital, Neurological Clinic of IPVZ)
- Course of manual medicine - Lumbalgia - possibilities of rapid diff. diagnosis and treatment in practice (2006, IPVZ)
- Epileptology for neurologists in preparation for attestation of the first degree (2002, IPVZ)
