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All Journal Neurona Indonesian Journal of Biomedicine and Clinical Sciences
Sejahtera, Desin Pambudi
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Differences in the clinical presentations of anti-NMDAR (anti-N-methyl-D-aspartate receptor) encephalitis with status epilepticus: a retrospective case series Sejahtera, Desin Pambudi; Satiti, Sekar; Mukhtar, Ishana Nafeeza; Andatu, Roshynta Linggar; Khairani, Atitya Fithri
Indonesian Journal of Biomedicine and Clinical Sciences Vol 56 No 3 (2024)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v56i3.15917

Abstract

Literature on anti-NMDAR (anti-N-methyl-D-aspartate receptor) encephalitis is limited in developing countries, including Indonesia. This retrospective observational case series explored the impact of early diagnosis and treatment on patient outcomes in four distinct cases of anti-NMDAR encephalitis with status epilepticus, and other related conditions, of patients referred to Dr. Sardjito General Hospital, Yogyakarta. Clinical data from May 2021 to August 2023 were collected through the review of medical records, encompassing demographic information, clinical presentation, history, laboratory results, imaging studies, EEG reports, interventions, and the progression of the disease. Four cases were reported, three of whom were diagnosed with anti-NMDAR and one with bacterial encephalitis, each presenting a variety of neuropsychiatric clinical symptoms, leading to hospitalization, extensive testing, and interventions to establish the definitive diagnosis. Cases 1 and 4 have a childhood history of seizures. The cases analyzed factors including the impact of childhood versus adulthood onset and the adherence to taking medicine regularly leading to exacerbation symptoms and relapses. Distinguishing anti-NMDAR encephalitis from related conditions, such as bacterial encephalitis, was further complicated in patients with varied neuropsychiatric presentations (seizures, hallucinations, irritable behavior, headaches) and responses to the treatment. Supporting investigation finds positive NMDAR testing and abnormal CT, MRI, and EEG results, contributed to definitive diagnoses. It could be concluded that comprehensive diagnostic investigations are important for prompt recognition of clinical characteristics, and early initiation of immunomodulatory therapy in managing anti-NMDAR encephalitis and related conditions in Yogyakarta, Indonesia.
NYERI KEPALA PASCATRAUMA: TELAAH EPIDEMIOLOGI DAN PATOFISIOLOGI Setyaningsih, Indarwati; Kurniandari, Nindriya; Habibi, Muhammad Najmi; Sejahtera, Desin Pambudi
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 5: Edisi Suplemen Neurona Bekerjasama dengan JogjaCLAN 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i5.867

Abstract

Post-traumatic headache (PTH) is one of the most common complications following mild traumatic brain injury (TBI). Its clinical presentation often resembles primary headache disorders, such as migraine or tension-type headache; however, it possesses a more complex and multifactorial pathophysiological basis. This article aims to review the epidemiological aspects and pathophysiological mechanisms of PTH based on recent literature. Globally, more than 69 million individuals experience TBI each year, and up to two-thirds of patients with mild TBI are reported to develop PTH. While most cases are transient, approximately 15–25% progress to persistent PTH. The pathogenesis of PTH involves interactions among structural damage, neurometabolic dysfunction, and neuroinflammatory processes that trigger activation of the trigeminovascular system and both peripheral and central sensitization. Cervical factors, hyperadrenergic mechanisms, and disturbances in the descending pain modulatory system further exacerbate symptoms. Advanced neuroimaging studies such as diffusion tensor imaging (DTI), Voxel-based morphometry (VBM), and magnetic resonance spectroscopy (MRS) provide supporting evidence of axonal injury, cortical thinning, and neuronal metabolic abnormalities associated with symptom persistence. A deeper understanding of the interaction among structural, metabolic, and inflammatory dysfunctions may serve as the foundation for developing more effective diagnostic and therapeutic strategies to improve patient’s clinical outcome. Keywords: post-traumatic headache, traumatic brain injury, neuroinflammation, central sensitization, peripheral sensitization
Co-Authors Andatu, Roshynta Linggar Habibi, Muhammad Najmi Khairani, Atitya Fithri Kurniandari, Nindriya Mukhtar, Ishana Nafeeza Satiti, Sekar Setyaningsih, Indarwati