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All Journal MNJ (Malang Neurology Journal) Neurona
Agustina, Lydia
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Health Professions Medicine & Pharmacology Neuroscience

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AUTOIMMUNE ENCEPHALITIS: DIAGNOSTIC AND TREATMENT APPROACH Hamdani, Ismi Adhanisa; Agustina, Lydia; Sasongko, Hari Andang; Gaharu, Maula Nuruddin; Rachmatullah, Fahmi; Ghufira, Nanda; Stevany, Nabila; Pawestri, Natasya Rahma Dewi; Fatahuddin, Rahaliya Salsabila; Natasya, Natasya
MNJ (Malang Neurology Journal) Vol. 10 No. 2 (2024): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.02.13

Abstract

Autoimmune encephalitis is a type of brain inflammation induced by an inappropriate immune response to a neuronal antigen, resulting in the generation of autoantibodies. Autoimmunity as important cause of encephalitis in recent years has not been much reported in Indonesia. Increased familiarity with autoimmune encephalitis among physician, not only neurologist, is extremely important for early detection. Prompt diagnosis and early immunotherapy leads to better prognosis in this potentially treatable disease, despite a long disease course. Autoimmune encephalitis is characterized by acute-subacute progressive neuropsychiatric symptoms with associated cognitive dysfunction, encephalopathy, psychiatric disorders, movement disorders and seizures, with anti-N-methyl-D-aspartate (NMDA) receptors encephalitis as the most common type. In addition to clinical features, further diagnostic investigations needed are brain magnetic resonance imaging (MRI), electroencephalography (EEG), cerebrospinal fluid (CSF) analysis, and autoantibody testing. Challenges in establishing diagnosis include wide range of clinical symptoms, absence of abnormalities in brain MRI, unspecified EEG findings, negative antibody testing, and limited availability of antibody testing in Indonesia. This literature review discusses the recognition, diagnosis and principle of treatment of autoimmune encephalitis.
EFEKTIVITAS TOKSIN BOTULINUM TIPE A TERHADAP SKALA SPASME, SKALA DEPRESI DAN KUALITAS HIDUP PASIEN HEMIFASIAL SPASME DI RSUD CIAWI Cornelia, Celine; Hamdani, Ismi Adhanisa; Gaharu, Maula N.; Agustina, Lydia
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 4 (2024): Volume 40, No 4 - September 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i2.560

Abstract

Introduction: Approximately 10/100.000 individuals worldwide experience hemifacial spasm (HFS) with a ratio of women-to-men at 2:1. Around 90% HFS patients face social life challenges, leading to self-isolation and decreased quality of life. Therapy modalities for HFS include oral therapy, botulinum toxin injection and surgery, but the oral therapy response rate is low. Aim: To determine the effectiveness of botulinum toxin type A injection on, spasm scale, depression scale and quality of life of HFS patients Methods: A quasi-experimental study was conducted at Ciawi Regional Hospital in May-December 2023. Data were collected using a total sampling technique, injection of Clostridium botulinum neurotoxin type A and succeeded by a 2-weeks, 1 month and 2 month follow-up. We used modified Jankovic scale, Mini International Neuropsychiatric Interview and HFS-7 criteria for our instruments. Results: 29 patients are included in this research, aged 30-93 years (31% are male and 69% are female). 69% suffered left-sided HFS and 31% right-sided HFS. 44,8% patients had hypertension. After 2 weeks post-injection, 81.8% patients with 2nd degree HFS and 71.4% patients with 1st degree HFS reported significant symptom improvement (p = 0.046 and 0.025). Both patient’s degree reported depression improvement without significant p-value (p = > 0.05) after 2 weeks until 2 month post injection. Increased quality of life (p = 0.001). Discussion: Clostridium botulinum neurotoxin type A injection is an effective treatment modality to improve spasm, depression and quality of life in HFS patients at Ciawi Regional Hospital. Keywords: Botulinum Toxin, Degree of Spasm, Experimental, Hemifacial Spasm, Quality of Life
Co-Authors Cornelia, Celine Fatahuddin, Rahaliya Salsabila Gaharu, Maula N. Gaharu, Maula Nuruddin Ghufira, Nanda Hamdani, Ismi Adhanisa Natasya Natasya Pawestri, Natasya Rahma Dewi Rachmatullah, Fahmi Sasongko, Hari Andang Stevany, Nabila