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All Journal Jurnal Sinaps Majalah Kedokteran Neurosains Cermin Dunia Kedokteran Magna Neurologica Neurona Acta Neurologica Indonesia
Riwanti Estiasari
Departemen Neurologi Fakultas Kedokteran Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo Jakarta
Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Journal : Neurona

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MULTIPEL SKLEROSIS PROGRESIF SEKUNDER, GEJALA KLINIS, DIAGNOSIS, DAN TATA LAKSANA Riwanti Estiasari; Nadia Devianca; Kartika Maharani; Darma Imran
NEURONA Vol 37 No 3 (2020)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i3.166

Abstract

Multiple sclerosis (MS) is a chronic inflammatory autoimmune disorder of the central nervous system (CNS) affecting the myelin. MS is very detrimental which causes disability and will reduce the productivity and quality of life of the patients, especially if it progressed to secondary progressive multiple sclerosis (SPMS) which there will be a continuous worsening of neurological deficits. Early detection of symptom progression can be done to overcome the problems that may occur in SPMS. By early detection, immediate therapy of SPMS can be given thus preventing the progression. It is therefore important for us to know the definition of SPMS, how to detect progression, and the treatment options for SPMS that will be explained in this literature review. Keywords: Progression, therapy, SPMS
Pendekatan Diagnosis dan Tata Laksana Multipel Sklerosis Sutanto, Anyelir; Widya Andini, Putri; Maharani, Kartika; Imran, Darma; estiasari, riwanti
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 1 (2023): Vol 40 No 1 (2023)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i1.420

Abstract

We reported three cases of young adults with typical and atypical neurological manifestations, supported by positive brain and spinal imaging findings, along with cerebrospinal fluid (CSF) analysis consistent with McDonald's criteria 2017 for multiple sclerosis (MS). Clinical manifestations varied with optic neuritis, myelopathy, vertigo, ataxia, and urinating problems in relapsing-remitting patterns in two cases and progressive in one other. Brain MRI showed T2-hyperintense lesion in cortical/juxtacortical, periventricular, and infratentorial areas, coupled with a spinal cord lesion shown in spinal MRI. The CSF analysis for oligoclonal band type II was positive in all cases. All three patients received relapse therapy with post-therapy clinical improvement, followed by long-term therapy with DMD (disease-modifying drugs) fingolimod, interferon β-1a, and one patient was treated with mycophenolate mofetil. Careful clinical observation was maintained to evaluate different relapse rates.
Gambaran Status Gizi Penderita Tumor Otak Primer dan Metastasis serta Faktor-faktor yang Memengaruhinya Aninditha, Tiara; Tanjung, Gloria; Andayani, Diyah Eka; Aman, Renindra Ananda; Estiasari, Riwanti; Yanuar, Ahmad; Sofyan, Henry Riyanto
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 39 No 3 (2022): Vol 39 No 3 (2022)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v39i3.280

Abstract

Introduction: According to the pathophysiology, weight loss is a specific marker for suspected malignancy. However, this is rarely found in cases of brain tumors. The presence of the blood brain barrier is thought to play a role in differentiating nutritional status in primary and metastatic brain tumors. Therefore, it is necessary to do this research. Aim: Knowing the description, prevalence, differences in nutritional status of patients with primary and secondary brain tumors, and the affecting factors. Methods: Cross-sectional study in patients with primary and secondary brain tumors at Cipto Mangunkusumo General Hospital in 2017-2019. Malnutrition was diagnosed using the GLIM (Global Leadership Initiative on Malnutrition) criteria. Data analysis used Chi-Square/Fisher and multivariate logistic regression. There were 333 subjects: 246 primary and 87 secondary brain tumors. Description of nutritional status of patients with primary brain tumors: 47.6% obese; 6.1% malnutrition; the rest were normal, while in secondary brain tumors: 25.3% were malnourished; 24.1% obese; the rest is normal. Secondary brain tumor at risk of malnutrition with RR 1.257 (95% KI 1.108-1.426), p<0.001. Factors influencing malnutrition were the type of primary/secondary brain tumor, gender, age, decreased consciousness, anorexia, gastrointestinal complaints, intraaxial lesions, multiple lesions, and the location of the lesions involving the frontal lobes. The independently related factor was multiple lesions with an aOR of 3,423 (95% KI 1.124-10.426), p 0.03. Conclusion: The nutritional status of patients with primary and secondary brain tumors was different, with higher levels of malnutrition in secondary brain tumors and higher obesity in primary brain tumors. The number of multiple lesions in the brain affects the occurrence of malnutrition.
Neuritis Optik Unilateral sebagai Manifestasi Klinis Myelin Oligodendrocyte Glycoprotein Antibody-Associated Disease (MOGAD) Tannika, Ayudhea; Estiasari, Riwanti; Maharani, Kartika
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 39 No 3 (2022): Vol 39 No 3 (2022)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v39i3.364

Abstract

Myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is an oligodendrocytopathic autoimmune disorder, characterized by demyelination and inflammation in the central nervous system, especially brain parenchyma and spinal cord. There are three main clinical manifestations in MOGAD: optic neuritis, transverse myelitis, and acute disseminated encephalomyelitis (ADEM). This case report presents a seropositive anti-MOG patient with early manifestation of optic neuritis. A 29 years old man presented with a complaint of blurry right vision and dull pain around his right eye in the last 5 months before hospital admission. Neurological examination revealed a right visual acuity of 2/60 and right relative afferent pupillary defect (RAPD). Brain MRI with contrast revealed an enhancement on the right optic nerve and nonspecific, multiple hyperintense lesions in bilateral frontal and parietal lobes. The patient’s result was reactive for anti-MOG antibody. After the administration of high dose methylprednisolone (1000 mg) for 5 consecutive days, the patient’s visual acuity was slowly improving; supported with an improvement on the Humphrey visual field analyzer. Immunosuppressant agent azathioprine was given as a long-term treatment without any worsening symptoms to this day. Unilateral optic neuritis could be an early clinical manifestation in MOGAD. It is important for clinicians to identify typical and atypical optic neuritis to be able to determine follow-through examination and workup and the associated differential diagnosis. Optic neuritis in MOGAD could be improved by the administration of high dose methylprednisolone, along with immunosuppressant therapy as long-term therapy
DIAGNOSIS DAN TATA LAKSANA NEUROMYELITIS OPTICA SPECTRUM DISORDER (NMOSD) Estiasari, Riwanti; Chandra, Fitria; Remana Sitinjak, Monalisa; Susanto, Arief; Maharani, Kartika; Imran, Darma
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 1 (2024): Vol 41 No 1 (2024): Volume 41, No 1 - Desember 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i1.576

Abstract

Neuromyelitis optica spectrum disorders (NMOSD) is an autoantibody mediated chronic inflammatory disease that predominantly affects optic nerves and spinal cord. NMOSD patients could experience visual disturbances, sensorimotor disorders, or autonomic disorders aligned with the pathological lesion involvement. Diagnostic criteria of the International Panel for NMO Diagnosis (IPND) 2015 are utilized to establish NMOSD diagnosis. Management of NMOSD encompasses initial and maintenance treatments that aim to prevent disease progression.
Co-Authors Ahmad Yanuar Aman, Renindra Ananda Andayani, Diyah Eka Aninditha, Tiara Anne Dina Soebroto Arief Susanto Arthur H.P. Mawuntu Chandra, Fitria Darma Imran Darma Imran Dewi Wulandari Erwin Widi Nugraha Firdausia, Salsabila Fitri Octaviana Gogor Meisadona Imran, Darma Kartika Maharani Kartika Maharani Kartika Maharani Maharani, Kartika Meisadona, Gogor Nadia Devianca Ni Nengah Rida Ariarini Pangeran, David Pradita Sari Purba, Maria Jheny Fulgensia Rahmad Mulyadi, Rahmad Remana Sitinjak, Monalisa Septiana Andri Wardana Soebroto, Anne Dina Sofyan, Henry Riyanto Sutanto, Anyelir Tanjung, Gloria Tannika, Ayudhea Widya Andini, Putri Yunus, Reyhan Eddy