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All Journal MNJ (Malang Neurology Journal) Malang Respiratory Journal Journal of Pain, Vertigo and Headache
Rahmawati, Dessika
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Other

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NEUROPATHIC PAIN IN PATIENT WITH POST OPERATIVE SCHWANNOMA: A CASE REPORT PRIMARY INTRADURAL EXTRAMEDULLAR SPINAL CORD TUMOUR Santoso, Widodo Mardi; Nurlela, Siti; Marhaendraputro, Eko Arisetijono; Rahmawati, Dessika
Malang Neurology Journal Vol 5, No 2 (2019): July
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2019.005.02.7

Abstract

Majority of spinal cord tumour is a benign tumour with symptoms are due to spinal cord compression. One of the symptoms that are often difficult to treat is a sensory deficit. The authors report a case of primary intradural extramedullar spinal cord tumour in 57-year-old man. This tumour was presenting symptoms of chronic low back pain, gradual progressive inferior paraplegia, and sensory deficit on both legs. MRI thoracal showed intradural lesion at Th 4-5-6, with isointensity on T1-weighted images and hyperintensity-isohomogen on T2-weighted images. The tumour was completely resected, and histopathology examination revealed schwannoma types. Patient showed a clinical improvement in motoric function noticeable after surgery, but showed sensory deficits sequelae requiring therapy for neuropathic pain.
SIDE EFFECTS OF TEMOZOLOMIDE CHEMOTHERAPY IN GLIOMA AND MANAGEMENT Sukmala Ratih, Dwita; Rahmawati, Dessika
MNJ (Malang Neurology Journal) Vol. 11 No. 2 (2025): 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.2025.011.02.11

Abstract

Glioma is the most common type of primary brain tumor and is characterized by aggressive growth, angiogenesis, and invasion. Current therapies for malignant glioma have limited efficacy, necessitating new treatment strategies.1 Every year, approximately 100,000 people worldwide are diagnosed with glioma. These tumors are categorized based on tumor histology and molecular alterations. Survival rates depend on tumor subtype, age, and gender.4 Glioblastoma is a specific type of glioma and is the most aggressive and malignant form. It is often linked to unfavorable outcomes and has few available treatment choices.2 Temozolomide is a drug used in the treatment of glioma, which is the most common primary malignant tumor of the Central Nervous System (CNS). It is a chemotherapy drug that is often used in combination with radiation therapy to treat gliomas. It works by damaging the DNA in cancer cells, which prevents them from dividing and growing. This agent may help slow or stop tumor growth. TMZ is often used in combination. Close monitoring of patients receiving bevacizumab or temozolomide is required to manage potential side effects resulting from the use of these regimens.3
A Rare Case: Adenocarcinoma Bronchogenic Dextra Std IVB on Gefitinib (15 months) accompanied by Decreased Visual Acuity, Bilateral Sensorineural Deafness and Psychiatric Disorders with No Radiological Evidence of Brain Metastasis Ensang Timuda, Caesar; Dwi Pratiwi, Suryanti; Rahmawati, Dessika; Yudhantara, Dearisa; Erawati, Dini; Indrasworo, Dyah; Prayitnaningsih, Seskoati
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.2

Abstract

Background: Leptomeningeal disease occurs in 3-5% of patients with lung cancer, mainly adenocarcinoma subtype. Adenocarcinoma is the most common histological finding in Asian women. Case: A 51-year-old woman with right-sided bronchogenic adenocarcinoma T4N3M1c Std IVB mutation(+) developed decreased vision, severe bilateral sensorineural deafness and psychiatric disorders after receiving Gefitinib 15 months. There was no evidence of brain metastasis from brain MRI. From evaluation of chest CT-scan, we found the disease was progressive and no Mutation Detected from ctDNA, so Gefitinib was discontinued. Conclusion: We found some difficulties in evaluating side effects of therapy and disease progression due to patient's condition in the form of decreased total vision, severe sensorineural deafness, and psychiatric disorders. However, because no radiological evidence of brain metastases was found, we suspect this patient suffered from leptomeningeal disease. Keywords: Lung Cancer, Adenocarcinoma, Gefitinib, Leptomeningeal Disease
PATHOPHYSIOLOGY, DIAGNOSIS, AND MANAGEMENT OF NEUROPATHIC PAIN Puteri, Lintang Firdhani Nabila; Rahmawati, Dessika
Journal of Pain, Headache and Vertigo Vol. 6 No. 2 (2025): September
Publisher : PERDOSNI (Perhimpunan Dokter Spesialis Neurologi 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/

Abstract

Background: Neuropathic pain is a type of chronic pain resulting from lesions or disorders of the somatosensory nervous system. This condition is often difficult to recognize and manage due to the complexity of its mechanisms and the variation in clinical symptoms. Objective: This article aims to review the pathophysiological mechanisms, diagnostic approaches, and management strategies for neuropathic pain based on current scientific literature. Result: The main mechanisms of neuropathic pain include ectopic activity, central sensitization, dysfunction of descending inhibitory pathways, and glial cell activation. Diagnosis is established through a combination of detailed history taking, neurological examination, screening tools such as DN4, and supporting investigations such as EMG-NCV, QST, skin biopsy, ultrasonography, and MRI. Pharmacological therapy includes the use of tricyclic antidepressants, SNRIs, anticonvulsants, and topical agents, with an individualized and stepwise approach. Advanced imaging techniques such as MRI and CT play a critical role in detecting structural lesions. Conclusion: The diagnostic and therapeutic approaches to neuropathic pain should be multimodal and mem-based. Integration of clinical and supporting examinations is key to improving diagnostic accuracy and therapeutic effectiveness.
DEVELOPMENT SCORING SYSTEM TO PREDICT IN-HOSPITAL MORTALITY IN STROKE PATIENTS IN INDONESIA Rahmalia Izzati, Fatma; Arisetijono, Eko; Rahmawati, Dessika; Hariyanti, Tita
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): 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.2026.012.02.04

Abstract

Background: Stroke is the third leading cause of death globally, and early prediction of in-hospital mortality risk is essential for improving clinical outcomes and optimizing resource allocation. However, no in-hospital mortality system applicable to both ischemic and hemorrhagic stroke currently exists in Indonesia. This study aims to identify significant predictors of in-hospital mortality among stroke patients, to develop an in-hospital mortality prediction score system, and to assess the performance of the score. Methods: This retrospective cohort study included stroke patients hospitalized at Dr. Saiful Anwar Hospital, Malang, Indonesia in January-December 2024, with data obtained from electronic medical records. Multivariate logistic regression with backward stepwise elimination was performed to identify predictors significantly associated with in-hospital mortality. Scoring weights were derived from regression coefficients. Model performance was assessed using accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the curve (AUC). Results: Eight significant predictors were identified: age ≥60 years, male sex, National Institute of Health Stroke Scale (NIHSS) ≥16, leukocytosis, hyperglycemia, hemorrhagic stroke type, pneumonia, and sepsis. These predictors were incorporated into an in-hospital mortality scoring system. The scoring system demonstrated an accuracy of 72.92%, sensitivity 80%, specificity 71.77%, PPV 31.37%, NPV 95.7%, and an AUC of 0.784. Conclusions: Eight out of thirteen proposed predictors were significantly associated with in-hospital mortality among stroke patients. Based on these predictors, a prognostic scoring system for in-hospital mortality was developed, demonstrating fair discriminative performance.
CLINICAL SPECTRUM AND DIAGNOSTIC OF NEUROFIBROMATOUS IN YOUNG AGES: SERIAL CASE Rahmaditta, Allyssa; Rahmawati, Dessika
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): 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.2026.012.02.21

Abstract

Background: Neurofibromatosis and schwannomatosis are neurocutaneous syndromes characterized by a genetic predisposition to the formation of Schwann cell tumors. Phenotypic overlap between NF2 (Neurofibromatosis Type 2)-related schwannomatosis and non-NF2 schwannomatosis often presents diagnostic challenges. Objective: To report two cases of neurofibromatosis in young patients with distinct clinical manifestations, highlighting diagnostic and therapeutic aspects. Contents: A case series study involving two patients diagnosed with neurofibromatosis at Dr. Saiful Anwar General Hospital, Malang, in 2025. Data were collected from anamnesis, physical examination, and ancillary tests including radiologic and histopathologic evaluations, followed by analysis to establish diagnosis and treatment planning. The first case, a 30-year-old male, presented with progressive limb weakness and bilateral hearing loss. MRI revealed bilateral vestibular schwannomas and multiple intradural schwannomas, consistent with NF2-related schwannomatosis. The second case, a 30-year-old female, experienced multiple neuropathic pain sites and tender subcutaneous nodules. Biopsy confirmed neurofibroma, consistent with non-NF2 schwannomatosis. Management included decompressive surgery and symptomatic therapy. Conclusion: Clinical manifestations of NF2 and schwannomatosis often overlap; thus, an integrated approach combining clinical, radiologic, histopathologic, and genetic findings is essential for accurate diagnosis. A multidisciplinary approach is required to optimize prognosis.  
Co-Authors Damayanti, Yulia Dwi Pratiwi, Suryanti Eko Arisetijono Ensang Timuda, Caesar Erawati, Dini Holifah, Holifah Indrasworo, Dyah Puteri, Lintang Firdhani Nabila Rahmaditta, Allyssa Rahmalia Izzati, Fatma Retnani, Diah Prabawati Seskoati Prayitnaningsih siti nurlela Sukmala Ratih, Dwita Tita Hariyanti Widodo Mardi Santoso, Widodo Mardi Yudhantara, Dearisa