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PERBANDINGAN METODE ORTODROMIK DAN ANTIDROMIK PEMERIKSAAN KECEPATAN HANTAR SARAF SENSORIS NERVUS MEDIANUS DAN NERVUS ULNARIS PADA PASIEN NEUROPATI Theresia Christin; Marissa Sylvia Regina; Erial Bahar
JURNAL KEDOKTERAN DAN KESEHATAN Vol 7, No 2 (2020)
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/JKK.V7I2.9638

Salah satu penyebab neuropati tersering pada ekstremitas atas adalah penekanan pada nervus medianus dan nervus ulnaris. Pemeriksaan kecepatan hantar saraf (KHS) sensoris sering dipraktikkan untuk mengidentifikasi ada atau tidaknya jejas/kelainan pada saraf yang diduga mengalami neuropati. Metode pemeriksaan KHS sensoris yang sering dipakai adalah ortodromik dan antidromik. Tujuan penelitian ini addalah untuk membandingkan pemeriksaan KHS sensorik ortodromik dengan antidromik yang menggunakan rangsang sinyal dengan arah yang berbeda. Penelitian cross sectional di RSUP dr. Mohammad Hoesin Palembang periode 15 Juli-15 September 2019 pada 64 subjek yang dicurigai menderita neuropati nervus medianus dan ulnaris yang memenuhi kriteria inklusi dan eksklusi, masing-masing dilakukan pemeriksaan KHS sensorik metode ortodromik dan antidromik, kemudian dibandingkan hasil elektroneuromiogramnya. Analisis data menggunakan uji hipotesis komparatif kappa. Hasil analisa statistik menunjukkan keeratan kesesuaian yang “kuat” dan bermakna dengan nilai k = 0,61-0,80 p <0,05 antara kedua metode ortodromik dan antidromik pada nervus medianus, sementara pada nervus ulnaris keeratan kesesuaian bervariasi, yakni pada durasi KHS dengan keeratan “sedang” k = 0,601 p <0,05, dan pada latensi serta amplitude KHS dengan keeratan “cukup” nilai k = 0,21-0,40 p <0,05. Kesimpulan penelitian ini adalah metode pengukuran KHS sensorik memiliki keeratan kesesuaian yang secara keseluruhan cukup baik sehingga kedua metode dapat digunakan dan mampu memberikan interpretasi kelainan yang serupa dalam pemeriksaan neuropati

Accuracy of Clinical Examination, Lumbosacral Radiography, and Electrodiagnosis in Suspected Patients With Lumbar Herniated Nucleus Pulposus Theresia Christin; Luther Theng; R.M. Faisal; Erial Bahar
Majalah Kedokteran Sriwijaya Vol 51, No 4 (2019): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v51i4.10235

Low back pain is a common health problem often complained around the world with prevalence of 12% -35%2. Low back pain is the second causes of patient consult in United State of America and become the etiology of patient under 45 years old disability.3 Apart from a number of strategies recommended for the causes of low back pain, the initial diagnosis and correct diagnosis of the pain location is of clinical importance. In Indonesia, diagnostic test for lumbosacral radiography, EDX and neurological clinic examination that might help to diagnose HNP have never been compared to MRI as gold standard. Many studies have tried to find diagnostic alternatives using other modalities to help with HNP screening such as myelographic CT scans, conventional myelography or discography, but those tests are invasive. Common test that is expected to help in screening is clinical neurological examination because it is easy to do, requires no fees, can be carried out by a neurology resident supervised by a neurologist and a neurologist himself, and can be done anywhere. The accuracy of neurological clinical examinations, along with lumbosacral radiography and electrodiagnosis in assessing signs of lumbar HNP as a screening method is compared to gold standard MRI.The study is a diagnostic study with a cross sectional approach. This research was conducted at the Department of Neurology, Dr. Mohammad Hoesin Hospital Palembang in the period of 6 months from February to July 2018. The study population were patients who were suspected of having lumbar HNP. Samples were patients with suspected lumbar HNP who came to Dr. RSUP. Mohammad Hoesin Palembang and conducted a Lumbosacral MRI examination and according to the research acceptance criteria (inclusion and exclusion criteria). We find that ischialgia history, lumbosacral radiographs, upright AP projections, electroneuromyograph (ENMG) and neurological clinical examinations can be used as a screening modality in diagnosing lumbar HNP and have an accuracy that approaches the gold standard examination, namely MRI.

Idiopathic Bilateral Simultaneous Facial Nerve Palsy (B-FNP) Theresia Christin; Ratri Wulandari; Luther Theng; Selly Marisdina
Majalah Kedokteran Sriwijaya Vol 52, No 1 (2020): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v52i1.11426

Background: Bilateral facial nerve palsy (B-FNP) is a rare clinical manifestation with incidence of 1 per 5 million people. Furthermore, it approximately accounts for 0.3 – 2 % of facial palsy cases. This B-FNP case is intricate in the diagnosis, finding the aetiology, and treatment that need hospitalization. Case Report: A male 64-year-old with bilateral facial nerve palsy that happened suddenly followed by difficulty in closing both eyes and facial abnormality without clear cause within 7 days of onset. Risk factor is hypertension stage 2. During neurological examination, there was bilateral peripheral facial nerve palsy grade IV in right side and grade III in the left side (House Brackmann grading system) that was not followed by other cranial nerve abnormality and motoric examination is normal. Supporting examinations such as lumbar puncture, thorax photo, and head MRI with contrast shows normal result. ENMG examination shows absent of blink reflex. Prednisone 60 mg orally was given with tapering off dosage 10 mg per day. Patient was hospitalized for 12 days and was discharge with good clinical improvement with bilateral peripheral facial nerve paralysis grade II in right side and grade I in left side. Conclusion: Bilateral facial nerve paralysis is a rare clinical manifestation and challenging in diagnosis. It is important to have a differential diagnosis in cases with bilateral cranial nerve palsy. Careful physical examination and appropriate supporting examinations such as laboratory and radiology in necessary to evaluate the underlying cause.

Ultrasound vs Nerve Conduction Studies: A Comparative Analysis in Carpal Tunnel Syndrome Diagnosis Hasnawi Haddani; Henry Sugiharto; Afriani; Theresia Christin; Legiran; Ferawaty
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1145

Background: Carpal tunnel syndrome (CTS) is a prevalent entrapment neuropathy. While nerve conduction studies (NCS) remain the gold standard for diagnosis, ultrasound (USG) offers a non-invasive alternative. This study aimed to compare the diagnostic accuracy of USG and NCS in CTS at Dr. Mohammad Hoesin General Hospital Palembang, Indonesia. Methods: A cross-sectional study was conducted on patients presenting with CTS symptoms. Demographic and clinical data were collected. NCS and USG assessments were performed, blinded to each other's results. USG measurements included the cross-sectional area at the carpal tunnel inlet (CSAc), proximal to the carpal tunnel (CSAp), and the difference between them (∆CSA). Diagnostic accuracy was calculated, and agreement was assessed using Cohen's kappa. Results: A total of 86 wrists from 49 patients were included. The mean age was 52 ± 11 years, with a female predominance (86%). The majority had mild CTS based on NCS (55.8%). USG measurements showed mean CSAc of 13.1 ± 3.5 mm², CSAp of 10.6 ± 3.0 mm², and ∆CSA of 2.5 ± 0.9 mm². ∆CSA had the highest sensitivity (92.2%), specificity (88.9%), and accuracy (91.9%), with substantial agreement with NCS (Kappa = 0.65). Conclusion: USG, particularly using ∆CSA, demonstrates high diagnostic accuracy in CTS, comparable to NCS. It can serve as a valuable tool, especially in settings with limited NCS availability.

DIAGNOSTIC ACCURACY OF CLINICAL SCORING SYSTEMS (NSS, NDS, AND TCSS) COMPARED TO ELECTROPHYSIOLOGICAL TESTING IN DIABETIC NEUROPATHY AMONG T2DM PATIENTS Muhlisa, Safitri; Theresia Christin; Yulianto Kusnadi; Erial Bahar
Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Vol. 12 No. 3 (2025): Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Univers
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/jkk.v12i3.689

Diabetic neuropathy is one of the most common chronic complications in diabetes mellitus patients and can significantly impair quality of life. Early diagnosis is essential, but limited availability of diagnostic tools such as electrophysiological testing in many healthcare facilities calls for more practical and efficient alternatives. This study aimed to compare the diagnostic accuracy of three clinical scoring systems—NSS (Neuropathy Symptom Score), NDS (Neuropathy Disability Score), and TCSS (Toronto Clinical Scoring System)—in detecting diabetic neuropathy among Type 2 DM patients at Dr. Mohammad Hoesin Hospital, Palembang. A cross-sectional design was employed, and findings revealed that TCSS had the highest accuracy (90.3%) compared to NDS (85.5%) and NSS (85.4%). TCSS also demonstrated the best balance of sensitivity (95.4%) and specificity (77.8%). All three instruments can serve as effective early screening tools, especially in healthcare settings with limited access to electrophysiological diagnostic facilities.

Ultrasound vs Nerve Conduction Studies: A Comparative Analysis in Carpal Tunnel Syndrome Diagnosis Hasnawi Haddani; Henry Sugiharto; Afriani; Theresia Christin; Legiran; Ferawaty
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1145

Background: Carpal tunnel syndrome (CTS) is a prevalent entrapment neuropathy. While nerve conduction studies (NCS) remain the gold standard for diagnosis, ultrasound (USG) offers a non-invasive alternative. This study aimed to compare the diagnostic accuracy of USG and NCS in CTS at Dr. Mohammad Hoesin General Hospital Palembang, Indonesia. Methods: A cross-sectional study was conducted on patients presenting with CTS symptoms. Demographic and clinical data were collected. NCS and USG assessments were performed, blinded to each other's results. USG measurements included the cross-sectional area at the carpal tunnel inlet (CSAc), proximal to the carpal tunnel (CSAp), and the difference between them (∆CSA). Diagnostic accuracy was calculated, and agreement was assessed using Cohen's kappa. Results: A total of 86 wrists from 49 patients were included. The mean age was 52 ± 11 years, with a female predominance (86%). The majority had mild CTS based on NCS (55.8%). USG measurements showed mean CSAc of 13.1 ± 3.5 mm², CSAp of 10.6 ± 3.0 mm², and ∆CSA of 2.5 ± 0.9 mm². ∆CSA had the highest sensitivity (92.2%), specificity (88.9%), and accuracy (91.9%), with substantial agreement with NCS (Kappa = 0.65). Conclusion: USG, particularly using ∆CSA, demonstrates high diagnostic accuracy in CTS, comparable to NCS. It can serve as a valuable tool, especially in settings with limited NCS availability.

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