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Maharani, Kartika
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Journal : Neurona

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Pendekatan Diagnosis dan Tata Laksana Multipel Sklerosis Sutanto, Anyelir; Widya Andini, Putri; Maharani, Kartika; Imran, Darma; estiasari, riwanti
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 1 (2023): Vol 40 No 1 (2023)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i1.420

Abstract

We reported three cases of young adults with typical and atypical neurological manifestations, supported by positive brain and spinal imaging findings, along with cerebrospinal fluid (CSF) analysis consistent with McDonald's criteria 2017 for multiple sclerosis (MS). Clinical manifestations varied with optic neuritis, myelopathy, vertigo, ataxia, and urinating problems in relapsing-remitting patterns in two cases and progressive in one other. Brain MRI showed T2-hyperintense lesion in cortical/juxtacortical, periventricular, and infratentorial areas, coupled with a spinal cord lesion shown in spinal MRI. The CSF analysis for oligoclonal band type II was positive in all cases. All three patients received relapse therapy with post-therapy clinical improvement, followed by long-term therapy with DMD (disease-modifying drugs) fingolimod, interferon β-1a, and one patient was treated with mycophenolate mofetil. Careful clinical observation was maintained to evaluate different relapse rates.
Neuritis Optik Unilateral sebagai Manifestasi Klinis Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) Tannika, Ayudhea; Estiasari, Riwanti; Maharani, Kartika
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 39 No 3 (2022): Vol 39 No 3 (2022)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v39i3.364

Abstract

Myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an oligodendrocytopathic autoimmune disorder, characterized by demyelination and inflammation in the central nervous system, especially brain parenchyma and spinal cord. There are three main clinical manifestations in MOGAD: optic neuritis, transverse myelitis, and acute disseminated encephalomyelitis (ADEM). This case report presents a seropositive anti-MOG patient with early manifestation of optic neuritis. A 29 years old man presented with a complaint of blurry right vision and dull pain around his right eye in the last 5 months before hospital admission. Neurological examination revealed a right visual acuity of 2/60 and right relative afferent pupillary defect (RAPD). Brain MRI with contrast revealed an enhancement on the right optic nerve and nonspecific, multiple hyperintense lesions in bilateral frontal and parietal lobes. The patient’s result was reactive for anti-MOG antibody. After the administration of high dose methylprednisolone (1000 mg) for 5 consecutive days, the patient’s visual acuity was slowly improving; supported with an improvement on the Humphrey visual field analyzer. Immunosuppressant agent azathioprine was given as a long-term treatment without any worsening symptoms to this day. Unilateral optic neuritis could be an early clinical manifestation in MOGAD. It is important for clinicians to identify typical and atypical optic neuritis to be able to determine follow-through examination and workup and the associated differential diagnosis. Optic neuritis in MOGAD could be improved by the administration of high dose methylprednisolone, along with immunosuppressant therapy as long-term therapy
DIAGNOSIS DAN TATA LAKSANA NEUROMYELITIS OPTICA SPECTRUM DISORDER (NMOSD) Estiasari, Riwanti; Chandra, Fitria; Remana Sitinjak, Monalisa; Susanto, Arief; Maharani, Kartika; Imran, Darma
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 1 (2024): Vol 41 No 1 (2024): Volume 41, No 1 - Desember 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i1.576

Abstract

Neuromyelitis optica spectrum disorders (NMOSD) is an autoantibody mediated chronic inflammatory disease that predominantly affects optic nerves and spinal cord. NMOSD patients could experience visual disturbances, sensorimotor disorders, or autonomic disorders aligned with the pathological lesion involvement. Diagnostic criteria of the International Panel for NMO Diagnosis (IPND) 2015 are utilized to establish NMOSD diagnosis. Management of NMOSD encompasses initial and maintenance treatments that aim to prevent disease progression.
Co-Authors Amelia, Dhea Arief Susanto bahar Chandra, Fitria Dewi Wulandari Eni Rosnija Firdausia, Salsabila Fitri Octaviana Heni Purwati Imran, Darma Laksono Trisnantoro Mulyadi Mulyadi Pangeran, David Rahmad Mulyadi Remana Sitinjak, Monalisa Reyhan Eddy Yunus Riwanti Estiasari Sudigdo, Agus Sutanto, Anyelir Syazali, Muhammad Tannika, Ayudhea Tria Wulandari Widiada, I Ketut Widya Andini, Putri