Vivien Puspitasari, Vivien
Department Of Neurology, Faculty Of Medicine, University Of Pelita Harapan Siloam Hospital Lippo Village

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POLA DISTRIBUSI NYERI ALIH DAN POSISI TUBUH PENCETUS NYERI SENDI SAKROILIAKA Yusak Mangara Tua Siahaan,* Vivien Puspitasari,* Vinson Hartoyo*
NEURONA Vol. 35 No. 2 Maret 2018
Publisher : Neurona Majalah Kedokteran Neuro Sains

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Abstract

INTRODUCTION SACROILIAC JOINT SIJ CONTRIBUTION TO CAUSE LOW BACK PAIN IS STILL WIDELY DEBATED SIJ IS HARDLY DISTINGUISHED FROM FACET JOINT PAIN OR OTHER MUSCULOSKELETAL DISORDER CAUSING LOW BACK PAIN AND LEADS TO DIAGNOSTIC DIFFICULTIES THERE ARE SEVERAL FACTORS THAT CONTRIBUTE TO SIJ PAIN DIAGNOSIS WHICH ARE REFERRAL PAIN AREA AND TRIGGERING POSITION
SINDROM TOLOSA HUNT DENGAN KETERLIBATAN SARAF OPTIKUS Astra Dea Simanungkalit,* Maria Larasati Susyono,** Vivien Puspitasari*
NEURONA Vol. 37 No. 1 Desember 2019
Publisher : Neurona Majalah Kedokteran Neuro Sains

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HUNT SYNDROME THS IS A VERY RARE CLINICAL SYNDROME WHICH IS CHARACTERIZED BY UNILATERAL HEADACHES ACCOMPANIED BY DYSFUNCTION AND PAINFUL OPHTHALMIC NERVES IN SOME CASES OPTIC NERVE INVOLVEMENT CAN BE FOUND DUE TO INFLAMMATION AT THE ORBITAL APEX
THE EFFECTIVENESS OF INTERFERON BETA-1A IN MANAGEMENT OF MULTIPLE SCLEROSIS: A CASE REPORT Puspitasari, Vivien; Sutanto, Anyeliria; Pangestu, Aristo Rinaldi
MNJ (Malang Neurology Journal) Vol. 6 No. 2 (2020): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

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Multiple sclerosis is a chronic autoimmune disease that attacks myelin in the central nervous system. About 2.5 million people worldwide have been diagnosed with multiple sclerosis. Its clinical presentation could vary according to the location of the lesion. Interferon beta is the most commonly used as immunomodulation therapy. However, its effectiveness for long-term use is still questionable. We report a case of 24-year-old woman with complaints of ataxia and limb weakness which were diagnosed as multiple sclerosis relapsing remitting (MSRR) and treated with interferon beta 1a for five years. During routine interferon beta 1a treatment three times a week, patient has still experienced four episodes of relapse in spite of good compliance. Hence, the rare presence of neutralizing antibodies was suspected. It commonly occurs after a year of interferon therapy, which is consistent with the patient’s treatment history. Further biomarker testing of drug-specific antibodies might be valuable to find out the possibility of interferon resistance
Sindrom-Guillain Barre Pada Pasien Demam Dengue Vivien Puspitasari
Medicinus Vol 5, No 3 (2016): June 2016 - September 2016
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v5i3.1172

Abstract

Guillain-Barre syndrome is an acute poliradiculopathy that characterizes as flaccid limb weakness subsequently after an infection disease. It is scarcely found to be triggered by the dengue virus infection. Here in a case report of 48-year-old male, presented as an ascending weakness of both limbs, following 2 days fever. Anti-dengue examination was found to be positive.Keywords: Guillain-Barre Syndrome, Dengue Fever
The Importance of Immunohistochemical Analysis in Silent Pituitary Adenoma Ivan William Harsono; Nathania Victoria Stevina; Vivien Puspitasari; Julius July
Medicinus Vol 6, No 3 (2017): June 2017 - September 2017
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v6i3.1150

Abstract

Pituitary adenoma contributes to 15% of all intracranial neoplasm. It is usually following benign course and some of them are silent (asymptomatic clinically, but hormone-secreting). Silent adenoma usually found incidentally or when the patients show mass effect (neurological deficits). Many of histologically aggressive silent adenoma subtypes are associated with invasiveness, recurrence and progression to clinically functioning adenomas. Aggressive silent adenoma radiologically tends to invade in downward direction, invading bone, sinus cavernosus, parasellar region. The nature of aggressive silent adenoma subtypes is differing in nature compared to benign nature of pituitary adenoma and should be confirmed immunohistochemically to determine the prognosis and anticipate the risk of recurrence or progression. The case illustration show a real case of 46 years old female progressive headache and visual disturbance diagnosed with non-functional pituitary macroadenoma but positive for more than one immunochemistry biomarker (plurihormonal aggressive silent adenoma).
Role of Span-75 in Determining Prognosis of Non-Thrombolysis Acute Ischemic Stroke Patients Sutanto, Anyeliria; Simanungkalit, Astra Dea; Yunita, Evelyn; Chandra, Anastasya; Pangestu, Aristo; Tiffani, Pamela
Medicinus Vol 9, No 2 (2020): February : 2020
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i7.2759

Abstract

Introduction: The SPAN-75 index is a modification of the SPAN-100 index as a prognostic tool in acute ischemic stroke patients. Previous studies were using SPAN index in cases of ischemic stroke patients treated with rTPA and in cases of intracerebral hemorrhage.Aim: To determine the role of the SPAN-75 index as a prognostic scoring in patients with acute ischemic stroke who did not get thrombolysis therapy.Method: The subjects were acute ischemic stroke patients at Siloam Hospitals Lippo Village who were not treated with thrombolysis therapy and had no disability before stroke onset during January to April 2019. Subjects were classified into a positive and negative of SPAN-75 index group. Disability due to stroke was assessed with Modified Rankin Score (mRS) at the time of admission and discharged from the hospital. This prospective study was analyzed by the Kruskal-Wallis test.Result: Forty subjects (average age of 57 years old) consisted of 31 negative and 9 positive of SPAN-75. Based on the Kruskal-Wallis test, the SPAN-75 index was positively associated with a more severe degree of stroke disability at the time of admission (p = 0.002), but not related to the change in the degree of disability when the patient was discharged from the hospital (p = 0.807). Age (p = 0.445) and gender (p = 0.578) had no significant relationship with the degree of disability of acute ischemic stroke.Conclusion: The SPAN-75 index is related to the degree of disability of acute stroke patients at the time of admission.
Isolated Abducens Nerve Palsy: A Case Report of Cerebral Pseudocyst of Dorello’s Canal Puspitasari, Vivien; Japutri, Josephine; Solansa, Tracy; Cenweikiawan, Anderson
Medicinus Vol 13, No 2 (2024): February
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v13i2.8108

Abstract

Background: Abducens nerve is the second longest intracranial path out of all of the cranial nerves. Abducens nerve pasly had a prevalence 11.3/100.000 and mostly seen in adults. Isolated abducens nerve palsy due to neoplastic lesion are rare and mostly related to skull base tumor.Case Presentation: We present a case of 57 years old woman with complaints of red right eye and worsening headache associates with diplopia on the right lateral gaze for three days prior admission. She was later diagnosed with isolated abducens nerve palsy associated to neoplasm cause in Dorello’s canal. Patient was then discharged with symptomatic therapy and educated for head posturing and avoid triggers.Conclusions: Abducens nerve palsy is the most common isolated ocular nerve palsy. The incidence of mass formation such as neoplastic lesion or cyst are rare.
Clinical Spectrum of Neurological Complaints in COVID-19: Experiences from a COVID-19 Referral Hospital in Indonesia Situmeang, Rocksy Fransisca V.; Simanungkalit, Astra Dea; Sutanto, Anyeliria; Pangestu, Aristo
Medicinus Vol 10, No 3 (2021): June 2021
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v9i1.4195

Abstract

Background: The main feature of COVID-19 is symptoms of respiratory system disorder, however, there has been an increase in reports of neurological symptoms that appear in COVID-19 patients. Several previous studies have linked SARS-CoV-2 with nervous system damage. Research studying neurological complaints in  confirmed COVID-19 patients in Indonesia is still lackingAim: To identify neurological, laboratory, and imaging findings in COVID-19 patients with neurological symptoms.Methods: This study was a cross-sectional observational study conducted at Siloam Hospitals Mampang, a COVID-19 referral hospital in South Jakarta. We analyzed medical records of confirmed COVID-19 patients during the period of April - July 2020. The data collected included demographic data, comorbidities, neurological manifestations, laboratory examinations, and neuroimaging.Results: There were 22 confirmed COVID-19 patients with neurological complaints referred to a neurologist. The mean age of patients was 60.4 (SD 15.8) years. The most common neurological complaints were altered mental status (50%), hemiparesis (27.3%), and tremors (22.7%). More than half of the patients (81.8%) had a comorbid condition or past history related to neurological symptoms. Laboratory examination results showed increased NLR (neutrophil-lymphocyte ratio) (50%), anemia (45.5%), and leukocytosis (40.1%). The most common neuroimaging feature was infarct (50%) in the brain CT scan.Conclusion: The neurological complaints in COVID-19 patients are mostly associated with exacerbation of pre-existing comorbidities as a result of the severe inflammatory process triggered by COVID-19. Further research is needed to establish the mechanism of nervous system dysfunction in COVID-19.
Case Report : Generalized Myasthenia Gravis Widjaja, Devita; Puspitasari, Vivien
Medicinus Vol 8, No 3 (2019): June 2019
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i5.2497

Abstract

Generalized myasthenia gravis is a rare case of autoimmune wherein the antibodies destroy the post-sinaptic acetylcholine receptors at skeletal muscle’s neuromuscular junctions. The clinical presentation is specific distributin of motoric deficit without sensoric deficit which diminished with rest and worsens with excessive use. We report a case of a woman 52 yo with symptoms of ptosis, diplopia and dificulty of swallowing. Repetitive nerve stimulation showed >10% decrement and prostigmin test was positive. The patient was treated and showed clinical improvement.
UNCONTROLLED DIABETES AS FACTOR AFFECTING COGNITIVE FUNCTION IN TYPE 2 DIABETES MELLITUS Simanungkalit, Astra Dea; Puspitasari, Vivien; Solansa, Tracy
MNJ (Malang Neurology Journal) Vol. 11 No. 1 (2025): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2025.011.01.21

Abstract

Background: Impairment or decline in cognitive function can be caused by various things, one of which is uncontrolled diabetes. In Indonesia, the research on the effect of blood sugar levels on cognitive function has been done, but still limited and less were using HbA1c. Objective: This research aims to find correlation between HbA1C level and cognitive function based on MoCA-Ina. Methods: This is a cross sectional study with a sample of 130 type 2 diabetes mellitus patients at Siloam Hospital Karawaci through a non-randomized purposive sampling method. Data collection was taken on January to May 2020 using medical record data for glycated hemoglobin (HbA1c) levels (cut off score 7%) and Montreal Cognitive Assessment ver. Indonesia (MoCA-Ina) score (cut off score 26) to evaluate the cognitive function. Statistical bivariate analysis performed using chi-square and multivariate analysis covariate variables using logistic regression. Results: Uncontrolled diabetes mellitus as shown by a high HbA1c level were significantly increase the risk of cognitive decline. The study showed a significant relationship between HbA1c levels with cognitive function (OR=5,98; CI 95% 2,25-15,58; p=0,000). A logistic regression analysis of various cognitive functions showed that memory was the most affected domain in patient with uncontrolled type 2 diabetes. Conclusion: Uncontrolled diabetes mellitus as shown by a high HbA1c level were significantly increase the risk of cognitive decline and the most affected domain was memory.