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All Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Narra J AKSONA
Priya Nugraha
Departemen Neurologi, Fakultas Kedokteran, Universitas Airlangga; RSUD Dr. Soetomo, Surabaya, Indonesia
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Penyakit Parkinson: Tinjauan Tentang Salah Satu Penyakit Neurodegeneratif yang Paling Umum Safia Alia; Hanik Badriyah Hidayati; Muhammad Hamdan; Priya Nugraha; Achmad Fahmi; Agus Turchan; Yudha Haryono
AKSONA Vol. 1 No. 2 (2021): JULY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (409.044 KB) | DOI: 10.20473/aksona.v1i2.145

Abstract

Penyakit Parkinson (PP) adalah penyakit neurodegeneratif paling umum ke dua yang melibatkan hilangnya neuron dopaminergik di otak tengah yang menyebabkan gejala motorik dan nonmotorik pada pasien yang mengalaminya. Gejala motorik ini dapat dikelola dan dikendalikan dalam  jangka waktu tertentu dengan menggunakan obat-obatan seperti levodopa. PP mempengaruhi jutaan orang di seluruh dunia, oleh karena itu tinjauan pustaka tinjauan pustaka tentang PP menjadi penting dan kami akan menyampaikan berbagai hal penting dari PP mulai dari patofisiologi hingga tindakan pengobatan baik medikamentosa maupun tindakan intervensi.
Hemichorea Onset Lambat pada Stroke Perdarahan Thalamus Kanan Diayanti Tenti Lestari; Priya Nugraha; Muhammad Hamdan
AKSONA Vol. 1 No. 2 (2021): JULY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (311.654 KB) | DOI: 10.20473/aksona.v1i2.140

Abstract

Pendahuluan: Chorea merupakan gangguan gerak involunter hiperkinetik. Chorea dapat disebabkan lesi vaskular serebral iskemik atau perdarahan. Gejala klinis melibatkan satu sisi tubuh dan lesi terletak di hemisfer otak kontralateral. Gangguan gerak pasca stroke paling sering dikaitkan dengan lesi di basal ganglia (44%) dan thalamus (37%). Laporan ini bertujuan untuk menyampaikan kasus hemichorea, gangguan gerak pascastroke perdarahan yang meliputi diagnosis, terapi dan prognosis. Kasus: Seorang laki-laki 59 tahun menderita tekanan darah tinggi, dislipidemia dan mengalami stroke perdarahan dengan kelemahan tubuh di sisi kiri. 5 bulan paca stroke pasien datang ke poliklinik rawat jalan saraf dengan keluhan lengan bawah kiri bergerak seperti menghentak. Pasien mengaku gerakan mulai muncul pada jemari tangan, terasa tertarik tarik otomatis menyentak, gerakannya tidak dapat dikendalikan. Pemeriksaan fisik dalam batas normal, pemeriksaan neurologis menunjukkan hemiparese sisi kiri dan gerakan otot berlangsung cepat, tanpa ritme, melibatkan satu anggota badan yaitu lengan kiri dan tes laboratorium menunjukkan dislipidemia. Pencitraan otak menunjukkan area hipointens pada thalamus kanan. Gejala dapat terkontrol dengan pemberian obat antidopaminergik (haloperidol) dan agonis GABA (klonazepam). Kesimpulan: Gangguan gerak dapat terjadi pascastroke sehingga penting untuk mengetahui dan mempertimbangkan terapi serta prognosis untuk kualitas hidup pasien pascastroke. Pemberian haloperidol dan klonazepam pada kasus hemichorea mengurangi klinis gerakan involunter.
Multiple Sistem Atrophy: Sebuah Laporan Kasus Edfina Rahmarini; Muhammad Hamdan; Priya Nugraha; Paulus Sugianto; Yudha Haryono
AKSONA Vol. 1 No. 1 (2021): JANUARY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (433.173 KB) | DOI: 10.20473/aksona.v1i1.102

Abstract

Pendahuluan: Multiple sistem atrophy adalah penyakit degeneratif yang dapat menyebabkan kecacatan bahkan kematian. Sedikit jurnal yang yang membahas tentang diagnosis dan penanganan multiple system atrophy secara menyeluruh. Kasus: Seorang laki-laki berusia 44 tahun datang ke poli saraf dengan keluhan kelemahan pada keempat ekstremitas dengan disertai gejala parkinsonisme yang khas. Pada pemeriksaan neurologis didapatkan gangguan fungsi serebelum. Pada pemeriksaan MRI kepala dengan kontras didapatkan gambaran khas suatu multipel system atrophy tipe cerebellar. Kesimpulan: Multipel system atrophy adalah kasus degeneratif yang bersifat jarang namun seringkali dapat menyebabkan kematian. Dibutuhkan diagnosis yang cepat dan penanganan yang memadai secara multidisiplin untuk mencegah beratnya gejala multiple system atrophy. Terapi simptomatik dan suportif sangat dibutuhkan untuk meningatkan kualitas hidup pasien.
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.
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i1.56523

Abstract

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.  
Manajemen Disfungsi Otonom Terbaru pada Penyakit Parkinson Nugraha, Priya; Puspamaniar, Vania Ayu
Majalah Kedokteran Indonesia Vol 75 No 4 (2025): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.75.4-2025-1526

Abstract

Since James Parkinson's 1817 initial description of Parkinson's disease (PD), autonomic dysfunction has been identified in PD patients. Parkinson disease (PD) is clinically heterogeneous due to motor and nonmotor symptoms, disease progression, and treatment responses. Autonomic dysfunction can cause a variety of symptoms, such as gastrointestinal, cardiovascular, urogenital, thermoregulatory, irregular pupillary movements, respiratory, and sleep symptoms. The idea that autonomic dysfunction may have a major role in PD patients' mobility, cognition, and health-related quality of life (HRQoL) is supported by several studies. Current management, as determined by the most recent guidelines, is crucial for updating physician expertise. Appropriate care is contingent upon a correct and timely diagnosis which will enhance the quality of life for PD patients. A thorough discussion of the clinical symptoms and current therapy will be provided in this article.
Co-Authors Alia, Safia Diayanti Tenti Lestari Edfina Rahmarini Fahmi Achmad Faisal Fahmi, Achmad Islamiyah, Wardah R. Lestari, Diayanti Tenti Machin, Abdulloh Mohammad Hasan Machfoed Muhammad Hamdan Muhammad Hamdan Paulus Sugianto Paulus Sugianto, Paulus Puspamaniar, Vania Ayu Puti, Nazla Ananda Rachmi Rahmarini, Edfina Safia Alia Suharto, Ade P. Turchan, Agus