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All Journal Jurnal Kedokteran Diponegoro Narra J AKSONA
Nugraha, Priya
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Motor improvement in Parkinson’s disease patients receiving caffeine adjuvants: A double-blind randomized controlled trial in Indonesia Hamdan, Muhammad; Suharto, Ade P.; Nugraha, Priya; Islamiyah, Wardah R.
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.826

Abstract

Parkinson's disease (PD) manifests as a movement and brain function disorder characterized by symptoms such as resting tremors, rigidity, bradykinesia, and postural instability, leading to disability among patients. The use of psychostimulants such as caffeine has been associated with the improvement of motor symptoms in PD patients; however, studies regarding the effect of caffeine adjuvant therapy on motor function among PD patients in the Indonesian population are lacking. The aim of this study was to evaluate motor improvement as measured by the change in scores of the Movement Disorder Society - Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS-III) among PD patients receiving caffeine adjuvant. A double-blind randomized controlled trial (RCT) was conducted among PD patients at Dr. Soetomo General Academic Hospital and Universitas Airlangga Hospital, Surabaya, Indonesia, from April to August 2023. A total of 27 patients were enrolled and randomly assigned to an intervention (receiving caffeine adjuvant, n=15) and control group (receiving placebo, n=12). Motor improvement was measured using the UPDRS III score prior to intervention and three weeks after. The Chi-squared test was used to analyze the difference in UPDRS III scores between the two groups. Motor improvement, as demonstrated by a reduction in the UPDRS III score, was observed in patients receiving caffeine adjuvant compared to those receiving placebo (80.0% vs 16.7%; p=0.004). Regarding the safety profile, only four out of 15 (26.6%) patients treated with caffeine reported minor adverse events. These conditions improved over time during the intervention. None of the 12 patients in the placebo reported adverse events. This study provides valuable insights into the initial dosage of caffeine that improves motor function in PD patients with minimum adverse effects.
Identifying Acute Ischemic Stroke with Hemichorea as A Clinical Manifestation: A Case Report Nugraha, Priya; Hamdan, Muhammad; Soedjono, Harris Kristanto; Valentine, Putri Permata
Jurnal Kedokteran Diponegoro (Diponegoro Medical Journal) Vol 13, No 5 (2024): JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL)
Publisher : Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dmj.v13i5.46243

Abstract

Focal brain lesions can induce abnormal involuntary movement disorders, including hemichorea, hemiballismus, parkinsonism, myoclonus, dystonia, tremor, and asterixis. The most common cause of focal brain lesions is stroke, followed by trauma, neoplasm, anoxia, vascular malformations, metabolic disease, and multiple sclerosis. Hemichorea-hemiballismus as an initial presentation of acute ischemic stroke is very rare, with an incidence rate of 0.54%. Case Presentation: A 65-year-old male with a past medical history of hypertension and diabetes experienced sudden, involuntary, non-rhythmic, and uncontrollable movements of the left extremity one day before being admitted to the hospital. A non-contrast CT scan of the head revealed acute cerebral infarction on the right basal ganglia. The symptoms of hemichorea improved with the initiation of haloperidol after three days of treatment. Regarding this case, acute ischemic stroke should be considered suppose a patient without hyperglycemia and with sudden onset of hemichorea visits to emergency room. 
Hemifacial Spasm Due to Contralateral Supratentorial Tumor: A Case Report Nugraha, Priya; Puti, Nazla Ananda Rachmi; Hamdan, Muhammad
AKSONA Vol. 5 No. 1 (2025): JANUARY 2025
Publisher : Universitas Airlangga

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Highlight: A rare case of hemifacial spasm due to contralateral supratentorial tumor. Improvement of hemifacial spasm after tumor removal treatment. A comprehensive patient examination can establish the correct diagnosis and treatment.   ABSTRACT Introduction: A rare neurological disorder known as hemifacial spasm (HFS) is characterized by involuntary, unilateral facial muscle contractions, typically caused by facial nerve irritation. In this report, we looked at a rare and fascinating case of hemifacial spasm (HFS) caused by a large contralateral supratentorial meningioma. The HFS went away amazingly after the tumor was removed and the patient was treated with corticosteroids. The complex connection between neurological disorders and intracranial tumors is highlighted in this case, along with potential treatment approaches for the patient. Cases: A 48-year-old woman complained of uncontrolled movements and spasms in her right eyelid and right lip corner for the past two years. The symptoms were accompanied by headaches, cognitive impairment, and a history of syncope. A neurological examination revealed right-sided central facial palsy. An MRI revealed a large atypical meningioma in the left frontal lobe. This resulted in significant brain displacement and perifocal edema, but no neurovascular contact with the 7th cranial nerve. Her hemifacial spasms significantly decreased following surgical resection, even with medication reduction. Conclusion:As an uncommon manifestation of contralateral supratentorial tumors, HFS requires careful evaluation of the patient’s history, physical examination, and radiological findings, as well as consideration of a wide range of potential causes. Accurate diagnosis and effective management can help reduce the risk of poor prognosis.  
Co-Authors Alia, Safia Fahmi, Achmad Hanik Badriyah Hidayati,* Mohammad Hasan Machfoed,* Kuntoro,** Soetojo,*** Budi Santoso,**** Suroto,***** Budi Utomo****** Islamiyah, Wardah R. Lestari, Diayanti Tenti Machin, Abdulloh Muhammad Hamdan Paulus Sugianto, Paulus Puti, Nazla Ananda Rachmi Rahmarini, Edfina Soedjono, Harris Kristanto Suharto, Ade P. Turchan, Agus Valentine, Putri Permata