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Rizal Nur Rohman
Neurologist, PKU Muhammadiyah Boja Hospital, Kendal, Central Java
Agriculture, Biological Sciences & Forestry Chemical Engineering, Chemistry & Bioengineering Dentistry Engineering Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Mechanical Engineering Medicine & Pharmacology Nursing Public Health Veterinary

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A 64 Year Old Woman With Neuropsychiatric Symptoms In Severe Dementia: A Case Report Dina Nurhayati; Rizal Nur Rohman
International Journal of Health Engineering and Technology Vol. 5 No. 3 (2026): SEPTEMBER 2026
Publisher : CV. AFDIFAL MAJU BERKAH

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55227/ijhet.v5i3.1203

Abstract

Neuropsychiatric symptoms (NPS) in dementia involve changes of behavior and personality, agitation, anxiety, depression, hallucinations, sleep or eating disorders. NPS leads to worse prognosis and accelerates the progression to severe dementia. A 64-year-old woman with agitation. Alloanamnesis found that since 3 years ago, patient has become senile, memory worsens and gets lost when traveling. Patient always repeats the same sentence, walks aimlessly, has sleep disorder and visual hallucinations. Patient is completely dependent on her family. Family history of illness, the patient's mother experienced the same symptoms. Neurological examination found hemiparesis sinistra sequelae since 1 year ago. Non-contrast head CT scan showed infarct in the right lentiform nucleus and brain atrophy with total Global Cortical Atrophy (GCA) scale 17. Hachinski score 4. Neuropsychiatric inventory (NPI) score 77. Patient’s previous treatment was not consistent. During initial treatment, the MMSE score 4, the MOCA Ina score 3, the IADL score 0. Patient received therapy with donepezil 5mg, olanzapine 10 mg, and fluoxetine 20 mg. Follow up result 1 month, MMSE score 10, MOCA Ina score 6, IADL score 2. The diagnosis of NPS in dementia is based on anamnesis, physical examination and supporting examination. Severe cognitive decline affecting domains of memory, language, attention and concentration, visuospatial function and executive function. Patient experienced clinical improvement after 1 month of pharmacological therapy. Early identification of neuropsychiatric symptoms in dementia patients is very important to provide appropriate management.
A 12 Year Old Boy With Suspected Charcot-Marie-Tooth: A Case Report Dina Nurhayati; Rizal Nur Rohman
International Journal of Health Engineering and Technology Vol. 5 No. 4 (2026): In Press
Publisher : CV. AFDIFAL MAJU BERKAH

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55227/ijhet.v5i3.1231

Abstract

Charcot-Marie-Tooth (CMT) is the most common hereditary neuropathy, with a prevalence of 1:2.500 in the Caucasian population. Clinical manifestations typically present during childhood or adolescence. A 12-year-old boy presented with difficulty walking. Alloanamnesis revealed that his growth and development had been appropriate for his age from birth until the age of 10 years. Over the past two years, he had developed gait abnormalities characterized by foot slapping while walking. Lower limb weakness had worsened seven days prior to hospitalization. The patient frequently fell, fatigued easily, and experienced pain in both legs. These symptoms were not preceded by fever or cough. Bowel and bladder functions were normal. He was born full-term, he had complete immunizations and no significant past medical history. His uncle had experienced similar symptoms. Physical examination revealed pes cavus and hammer toes. Neurological examination revealed lower limb muscle strength of 2/5, decreased patellar tendon reflexes, and negative pathological reflexes. Sensory function was difficult to evaluate. ENMG was not performed because the patient's parents refused referral. The patient showed clinical improvement following symptomatic pharmacological therapy and physical exercise therapy. The patient's clinical manifestations were consistent with typical features of CMT, including distal weakness, foot deformities, and loss of reflexes. Genetic testing, electrophysiological examination, and nerve biopsy could not be performed due to limited facilities. The clinician's role is crucial in establishing an initial diagnosis based on anamnesis and physical examination. Early detection may facilitate timely rehabilitation interventions to improve the patient's quality of life.
Co-Authors Dina Nurhayati Dina Nurhayati