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All Journal MNJ (Malang Neurology Journal) Acta Neurologica Indonesia
Ketaren, Retno Jayantri
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Medicine & Pharmacology Neuroscience Public Health

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THE PREDISPOSING FACTORS OF PIRIFORMIS SYNDROME: STUDY IN A REFERRAL HOSPITAL Siahaan, Yusak Mangara Tua; Ketaren, Retno Jayantri; Hartoyo, Vinson; Tiffani, Pamela
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.2019.005.02.5

Abstract

Background: Piriformis syndrome is a neuromuscular condition characterized by hip and gluteal pain caused by abnormality of piriformis muscle. In clinical practice, this syndrome is usually misdiagnosed with other spinal disorders. There is no specific test in diagnosing piriformis syndrome, therefore by understanding the characteristics and predisposing factors, clinicians may be more aware in diagnosing this syndrome.
Objective: To investigate the characteristics and predisposing factors of piriformis syndrome.Methods: A descriptive study was conducted on patients with gluteal pain in a referral hospital. Diagnosis was established by block injection on piriformis muscle and showed clinical improvement afterwards. Demographic characteristics, predisposing factors, and physical examination were analyzed. The data is collected and processed by SPSS 20.0.Results: The total of 65 patients were evaluated, with a male to female ratio 1:3. As much as 47.7% of patients were > 60 years old. Average weight was 60 kg and BMI (Body Mass Index) was within normal range (58.9%). Most subjects were housewives (55.4%) and the majority of subjects had history of microtrauma such as sitting on rigid surfaces (36.9%), walking or running long distances (18.5%), and cross-legged sitting (10.8%). Average sitting per day was approximately 5 hours. In 56.9% of subjects, exercises were conducted. There was no history of back pain in 81.5% of subjects.Conclusion: Our study showed age and housewives characteristics differ with other studies. The most predisposing factors were history of microtrauma, female, age, and normal BMI.
EFFECT OF LOW-DOSE BOTULINUM TOXIN ON HEMIFACIAL SPASM SEVERITY Wirawan, Clarissa; Siahaan, Yusak Mangara Tua; Suryawijaya, Evlyne Erlyana; Ketaren, Retno Jayantri
MNJ (Malang Neurology Journal) Vol. 12 No. 1 (2026): January
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.2025.012.01.02

Abstract

Background: Hemifacial spasm is a condition in which there are unilateral contractions of facial muscles. One of the most effective forms of treatment is botulinum toxin injections. However, this therapy only temporarily relieves symptoms, so repeated injections are necessary. This may place a significant economic strain on patients. Due to this, this study aims to see if low-dose botulinum toxin reduces the severity of hemifacial spasm. Objective: To find out whether there is an effect of low-dose botulinum toxin on the severity of hemifacial spasm. Methods: This study is a paired comparison test with a retrospective cohort design. Primary (HFS Score) and secondary (medical record) data was collected from hemifacial spasm patients at Siloam Hospitals Lippo Village Building B. Results: Data was collected from the 36 patients that fulfilled the inclusion and exclusion criteria. All patients were treated with 10 U or less of botulinum toxin. Results show that for HFS Clinical there was a decrease from a mean of 13,03 ± 2,077 to 6,44 ± 2,311 (p < 0,001), whereas HFS Subjective decreased from a mean of 401,53 ± 229,748 to 95,42 ± 151,607 (p < 0,001). Both components have a p-value < 0,001, making it statistically significant. Conclusion: Low-dose botulinum toxin affects the severity of hemifacial spasm in patients at Siloam Hospitals Lippo Village Building B.
Epilepsy As A Rare Intracranial Complication of Pansinusitis: A Case Series Samudra, Edeline; Ketaren, Retno Jayantri
Acta Neurologica Indonesia Vol. 4 No. 01 (2026): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

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Abstract

Introduction: Epilepsy is a condition characterized by recurrent and unpredictable seizures with an underlying mechanism that remains incompletely understood. A hallmark feature is over-synchronized neuronal discharge due to the loss of inhibitory control over glutamatergic neurons, with neuroinflammation being a potential contributing factor. Case Report: We report two cases of epilepsy in patients with a history of pansinusitis. A 14-year-old male experienced a first-onset generalized seizure, while a 23-year-old female presented with recurrent focal-to-bilateral seizures. CT scans revealed pansinusitis, predominantly affecting the bilateral frontal sinuses with bilateral ostiomeatal complex blockage in one patient, and the maxillary sinuses with an open bilateral ostiomeatal complex in the other patient. No evidence of intracranial infection or other epilepsy causes were found, suggesting epilepsy as an intracranial complication (IC) of pansinusitis. One patient was managed with medication, while the other underwent functional endoscopic sinus surgery. (FESS), revealing sinonasal polyps on histology. Discussion: ICs, including epilepsy, are rare but serious complications of pansinusitis and can lead to disabling neurological sequelae. The most common source of IC is frontal sinusitis, followed by ethmoid, sphenoid, and maxillary sinusitis. ICs occur via direct infection spread through dehiscent bone or through natural pathways, such as the olfactory foramina. Neuroinflammation can activate microglia and trigger reactive astrogliosis, leading to inflammatory cascades, neurotransmitter imbalances, and ion channel dysfunction. Conclusion: We have presented rare cases of epilepsy as an IC of pansinusitis, highlighting the need for thorough evaluations in epilepsy patients without known intracranial infections, including investigations for other potential infectious sources.
Co-Authors Hartoyo, Vinson M.T. Siahaan, Yusak Samudra, Edeline Suryawijaya, Evlyne Erlyana Tiffani, Pamela Wirawan, Clarissa