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Lumbar puncture constitutes the simplest method of collecting the cerebrospinal fluid for examination. It is an easy, quick and safe procedure to be applied to most of patients. Lumbar puncture is still commonly use in diagnostics of the nervous system diseases. It provides important data on intracranial pressure and on the composition of the cerebrospinal fluid. It also allows for an introduction of contrast for radiological examination and for intrathecal introduction of drugs.

Ultrasonography is a noninvasive, repeteable and safe technique enabling assessment of location and patency of extra- and intracerebral arteries as well as evaluation of collateral circulaton in severe abnormalities of these vessels. Using ultrasonography allows monitoring changes in blood flow at different stages of the disease, during therapy, during and after endarterectomy.

Carotid arteries evaluation plays an important role in secondary prevention of stroke. Ultrasound Doppler Duplex methods can quantify the degree of extracranial carotid stenosis and surface morphology of carotid plaques.

Embolism to the brain can be arterial or cardiac origin. They are cause of 20% of ischemic stroke. They occurs mostly in patients with atrial fibrillation. We present the methodology and data of major study collaborative in prevention or stroke in patients with atrial fibrillation. Meta-analysis revealed a 60-70% reduction of risk for stroke in patients treated with warfarin, as compared with placebo.

In paper was made review of most important problems in symptomatic treatment of multiple sclerosis (urinary balder dysfunction, tremor, spasticity, sexual disorders, pain). In each case the symptomatic treatment should be maximal adapted to individual need of every patient. The symptomatic treatment has no influence on the course of the disease, but limits number of complications and in this way increases the quality of life and indirectly decreases morbidity.

Management of first-ever-in life epileptic seizure in adults and adolescents: current opinions Management of first epileptic seizure in adults and adolescents is discussed, acute symptomatic seizures being excluded. When a diagnosis of first idiopathic or remote symptomatic seizure is established, antiepileptic treatment is to be considered. Controversies still exist about the problem of early treatment after first seizure. None of available clinical trials has proven greater benefit of early treatment vs. deferred treatment in terms of long-term prognosis, neither has prognostic factors been defined. Introduction of antiepileptic drugs (AEDs) may cause adverse drug reactions, including exacerbation of seizures. Thus, further studies are required to decide whether people should be treated after their first epileptic seizure. Recently started study of early epilepsy and single seizures was presented.

In the past years we have observed a growing interest in botulinum toxin (BTX) as an important therapeutic agent in the treatment of neurological disorders characterized by excessive muscular activity. The article describes the most popular clinical applications and efficacy of BTX injections.

The article is a survey of papers concerning knowledge of stroke signs, symptom s and risk factors among patients, healthy people and medical staff of several countries. There are also presented factors delaying hospital admission in acute stroke, organization and effectiveness of American Emergency Medical Services and Emergency Departments. Comparison of diagnostic management and medical therapy of cerebral vascular diseases between primary care physicians of UK and USA is discussed.