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Bayuangga, Halwan Fuad
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VERTIGO SENTRAL: TINJAUAN TERKINI MENGENAI PATOFISIOLOGI DAN STRATEGI DIAGNOSIS Sutarni, Sri; Setyaningrum, Cempaka Thursina Srie; Ar Rochmah, Mawaddah; Bayuangga, Halwan Fuad
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.v41i5.865

Abstract

Recent advances have fundamentally reshaped the clinical and pathophysiological landscape of central vertigo, moving beyond a simplistic brainstem model to a sophisticated understanding of a distributed central vestibular network. This network, encompassing the brainstem, cerebellum, thalamus, and cortex, provides a robust framework for explaining how disruptions from stroke, demyelination, or functional disorders produce diverse symptoms. In parallel, diagnostic paradigms have evolved dramatically. The advent of quantitative ocular motor testing, epitomized by the HINTS protocol and enhanced by video-head impulse testing (vHIT), now allows for highly sensitive bedside identification of central causes in acute settings. Furthermore, advanced neuroimaging techniques, including optimized diffusion-weighted and vessel wall MRI, have revolutionized our ability to detect subtle posterior fossa infarcts and vascular pathology. These mechanistic and technological insights have also refined our perspective on specific syndromes, solidifying vestibular migraine and persistent postural-perceptual dizziness (PPPD) as central disorders of sensory integration. Ultimately, the integration of this modern network-based pathophysiology with targeted diagnostic tools is establishing a new standard of care, significantly improving diagnostic accuracy, enabling timely intervention, and guiding future therapeutic development for patients with central vertigo. Keywords: Vestibular network, HINTS examination, neuroimaging, acute vestibular syndrome, central vertigo
PROFIL SEROLOGI MYASTHENIA GRAVIS: TINJAUAN ATAS TIPE, KARAKTERISTIK, DAN RELEVANSI KLINIS AUTOANTIBODI Asmedi, Ahmad; Bayuangga, Halwan Fuad
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.v41i5.869

Abstract

Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction characterized by muscle weakness and fatigability. Understanding the serological profile of MG is key to accurate diagnosis and management. This literature review discusses the types and characteristics of autoantibodies in MG and their clinical relevance. Autoantibodies against the acetylcholine receptor (Anti-AChR) are the most common, found in the majority of generalized MG cases, and their pathogenesis involves antigenic modulation, ligand blockade, and complement activation. This subtype has a strong correlation with thymic abnormalities such as hyperplasia and thymoma. Autoantibodies against MuSK and LRP4 define other MG subtypes with distinct clinical phenotype, MuSK-MG often presents with severe bulbar symptoms, while LRP4-MG tends to be milder. A recommended diagnostic approach is algorithmic, starting with Anti-AChR testing, followed by Anti-MuSK and Anti-LRP4 in seronegative cases. Mapping this serological profile enables neurologists to achieve a precise diagnosis, predict disease course, and determine personalized therapy strategies, including the choice of immunomodulators and evaluation for thymectomy. Thus, serological classification has become the foundation of a precision neurology approach in managing myasthenia gravis. Keywords: Anti-AChR, Anti-LRP4, Anti-MuSK, Myasthenia gravis, Thymoma
PENDEKATAN TERKINI DALAM DIAGNOSIS DAN TATA LAKSANA NEUROSIFILIS Satiti, Sekar; Bayuangga, Halwan Fuad; Aifa, Bardatin Lutfi
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.v41i5.871

Abstract

Neurosyphilis is a manifestation of Treponema pallidum infection involving the central nervous system which may occur at any stage of syphilis. This condition remains a global health concern with increasing incidence, particularly among individuals coinfected with human immunodeficiency virus (HIV). Its broad and often nonspecific clinical spectrum poses significant challenges for both diagnosis and management. This review discusses current approaches to the diagnosis and management of neurosyphilis based on the latest guidelines from the Centers for Disease Control and Prevention (CDC), the British Association of Sexual Health and HIV (BASHH), and the European Guidelines. The diagnosis of neurosyphilis is established through the integration of clinical findings, treponemal and nontreponemal serologic tests, and cerebrospinal fluid (CSF) analysis. Parenteral penicillin G for 10–14 days remains the first-line therapy in all major international guidelines. Ceftriaxone, doxycycline, or a combination of amoxicillin and probenecid may serve as alternative regimens in patients with penicillin allergy, although penicillin desensitization is still recommended whenever feasible. Corticosteroids, such as prednisolone, may be used prophylactically to prevent the Jarisch–Herxheimer reaction. Post-treatment monitoring through periodic clinical, serologic, and CSF evaluations is essential to ensure eradication of infection and prevent reinfection. A comprehensive diagnostic approach, early detection, appropriate antimicrobial therapy, and long-term follow-up are key determinants for improving outcomes in patients with neurosyphilis. Keywords: neurosyphilis, Treponema pallidum, neurosyphilis diagnosis, penicillin G, ceftriaxone