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AUTOIMMUNE ENCEPHALITIS: DIAGNOSTIC AND TREATMENT APPROACH Hamdani, Ismi Adhanisa; Agustina, Lydia; Sasongko, Hari Andang; Gaharu, Maula Nuruddin; Rachmatullah, Fahmi; Ghufira, Nanda; Stevany, Nabila; Pawestri, Natasya Rahma Dewi; Fatahuddin, Rahaliya Salsabila; Natasya, Natasya
MNJ (Malang Neurology Journal) Vol. 10 No. 2 (2024): 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

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.02.13

Autoimmune encephalitis is a type of brain inflammation induced by an inappropriate immune response to a neuronal antigen, resulting in the generation of autoantibodies. Autoimmunity as important cause of encephalitis in recent years has not been much reported in Indonesia. Increased familiarity with autoimmune encephalitis among physician, not only neurologist, is extremely important for early detection. Prompt diagnosis and early immunotherapy leads to better prognosis in this potentially treatable disease, despite a long disease course. Autoimmune encephalitis is characterized by acute-subacute progressive neuropsychiatric symptoms with associated cognitive dysfunction, encephalopathy, psychiatric disorders, movement disorders and seizures, with anti-N-methyl-D-aspartate (NMDA) receptors encephalitis as the most common type. In addition to clinical features, further diagnostic investigations needed are brain magnetic resonance imaging (MRI), electroencephalography (EEG), cerebrospinal fluid (CSF) analysis, and autoantibody testing. Challenges in establishing diagnosis include wide range of clinical symptoms, absence of abnormalities in brain MRI, unspecified EEG findings, negative antibody testing, and limited availability of antibody testing in Indonesia. This literature review discusses the recognition, diagnosis and principle of treatment of autoimmune encephalitis.

Gambaran Pengetahuan Perawat Poliklinik dan IGD terhadap Penyakit Parkinson Felix, Felix; Adhanisa Hamdani, Ismi
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 1 (2023): Vol 40 No 1 (2023)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i1.459

Introduction: Early detection and prompt treatment in ParkinsonÃ¢â‚¬â„¢s Disease (PD) can improve patientsÃ¢â‚¬â„¢ quality of life. The complexity of PD requires multidisciplinary team management. Nurses play roles in explaining nursing diagnosis and interventions such as motor function and fall risk, dysautonomia, disorder of communication and sleep, adherence to treatment, and advance stage PD treatment. Aim: To find out the description of the knowledge of outpatient and emergency department nurses regarding Parkinson's Disease at Ciawi Regional General Hospital. Methods: Observational descriptive study with a cross-sectional design using a questionnaire that has been tested for validity and reliability. Results: The majority of respondents are aged 30-40 years (60.4%), with educational level Diploma-3 (78.2%). About half of them have interacted with patients with PD (56.4%), but most of them have never received education about PD (62.4%). Majority level of knowledge about PD is sufficient (40.6%). The level of sufficient knowledge was obtained from respondents with educational level Diploma-3, aged 30-40 years, work experience > 10 years, and have interaction with patients with PD. Discussion: The level of knowledge of nurses at Ciawi Regional Hospital was mostly at 41 (40.6%), followed by a good level of knowledge at 32 (31.7%), and less at 28 (27.7%). This study is the first in Indonesia, and shows the need to increase the knowledge of PD among nurses as part of a multidisciplinary team. Education programs may have roles in increasing the level of knowledge regarding PD. Keywords: Knowledge, Multidisciplinary, Nurse, ParkinsonÃ¢â‚¬â„¢s Disease.

EFEKTIVITAS TOKSIN BOTULINUM TIPE A TERHADAP SKALA SPASME, SKALA DEPRESI DAN KUALITAS HIDUP PASIEN HEMIFASIAL SPASME DI RSUD CIAWI Cornelia, Celine; Hamdani, Ismi Adhanisa; Gaharu, Maula N.; Agustina, Lydia
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 4 (2024): Volume 40, No 4 - September 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i2.560

Introduction: Approximately 10/100.000 individuals worldwide experience hemifacial spasm (HFS) with a ratio of women-to-men at 2:1. Around 90% HFS patients face social life challenges, leading to self-isolation and decreased quality of life. Therapy modalities for HFS include oral therapy, botulinum toxin injection and surgery, but the oral therapy response rate is low. Aim: To determine the effectiveness of botulinum toxin type A injection on, spasm scale, depression scale and quality of life of HFS patients Methods: A quasi-experimental study was conducted at Ciawi Regional Hospital in May-December 2023. Data were collected using a total sampling technique, injection of Clostridium botulinum neurotoxin type A and succeeded by a 2-weeks, 1 month and 2 month follow-up. We used modified Jankovic scale, Mini International Neuropsychiatric Interview and HFS-7 criteria for our instruments. Results: 29 patients are included in this research, aged 30-93 years (31% are male and 69% are female). 69% suffered left-sided HFS and 31% right-sided HFS. 44,8% patients had hypertension. After 2 weeks post-injection, 81.8% patients with 2nd degree HFS and 71.4% patients with 1st degree HFS reported significant symptom improvement (p = 0.046 and 0.025). Both patientÃ¢â‚¬â„¢s degree reported depression improvement without significant p-value (p = > 0.05) after 2 weeks until 2 month post injection. Increased quality of life (p = 0.001). Discussion: Clostridium botulinum neurotoxin type A injection is an effective treatment modality to improve spasm, depression and quality of life in HFS patients at Ciawi Regional Hospital. Keywords: Botulinum Toxin, Degree of Spasm, Experimental, Hemifacial Spasm, Quality of Life

PENDEKATAN DIAGNOSIS DEMENSIA VASKULAR : LAPORAN KASUS Hong, Vicky; A. Hamdani, Ismi; Agustina, Lydia
PREPOTIF : JURNAL KESEHATAN MASYARAKAT Vol. 8 No. 1 (2024): APRIL 2024
Publisher : Universitas Pahlawan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/prepotif.v8i1.26642

Demensia vaskular adalah penurunan kognitif multidomain dengan gangguan aktivitas kehidupan sehari-hari yang diakibatkan oleh penyakit serebrovaskular, baik stroke iskemik maupun stroke hemoragik. Demensia vaskular adalah penyebab demensia yang paling umum kedua setelah demensia Alzheimer pada orang usia lanjut (di atas 65 tahun). Demensia vaskular perlu didiagnosis sedini mungkin. Pada kasus gangguan kognitif, diagnosis dan intervensi dini akan memberikan prognosis yang lebih baik, terutama dalam memperlambat penurunan kognitif, aspek fungsional, dan kualitas hidup. Pendekatan diagnostik untuk demensia vaskular menggunakan kriteria yang ada melalui anamnesis, pemeriksaan fisik, skrining neurokognitif dan pencitraan. Alat diagnostik untuk skrining demensia vaskular termasuk The Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Penilaian Kognitif Montreal (MoCA), Pemeriksaan Status Mental Mini (MMSE), dll. Simpulan laporan kasus ini ialah penggunaan kriteria diagnostik dan pemeriksaan akan mengarahkan kepada diagnosis yang tepat. Kami menyajikan kasus demensia vaskular pada pasien berusia 74 tahun yang memiliki riwayat stroke iskemik selama 9 tahun. Keluhan utamanya adalah pelupa, tetapi ternyata skrining neurokognitif menunjukkan adanya gangguan kognitif multidomain. Pasien bergantung penuh dalam aktivitas kehidupan sehari-hari. CT scan kepala menunjukkan infark lakunar multipel dan atrofi otak.

Tuberculous Meningoencephalitis in Lost To Follow-Up Patient: A Case Report Graciela, Yemima; Wisnuwardhani, Dian; Hamdani, Ismi Adhanisa
Jambi Medical Journal : Jurnal Kedokteran dan Kesehatan Vol. 12 No. 1 (2024): JAMBI MEDICAL JOURNAL: Jurnal Kedokteran dan Kesehatan
Publisher : FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN UNIVERSITAS JAMBI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22437/jmj.v12i1.29103

Background: Tuberculous meningoencephalitis (TBME) is a rare extrapulmonary TB that accounted for less than 1-2% with high mortality and morbidity rate. Loss of follow-up (LTFU) TB cases are also associated with worse prognosis, treatment failure, drug-resistant cases, decompensations, and complications. The objective of this study is to present a TBME case in LTFU patient as both conditions are correlated with worse outcomes for the patient. Case report: A 20-year-old man with a history of discontinued TB therapy presented to the emergency room (ER) with complaints of depressed consciousness, absence seizure, fever, shivers, nausea, vomiting, and holo-cranial headache. The diagnosis of TBME was confirmed by contrast-enhanced radiological findings, detection of M. tuberculosis in sputum, and blood investigations. Early initiation of anti-tuberculous drugs was given and showed marked clinical improvement followed by complete relief after a month follow-up. Conclusion: TBME should be diagnosed in patients living in high-rate TB countries with presumptive symptoms and signs supported by laboratory investigations as well as radiological findings to initiate early treatment. LTFU patients should be monitored with family or social group support while improving TB regimens in healthcare facilities. Keywords: Tuberculosis, meningoencephalitis, loss-to-follow up

One and a Half Syndrome and Internuclear Ophthalmoplegia as Neuro-Ophthalmological Manifestations in Patients with Brainstem Stroke: A Case Series Mahardhika Maghfirani Sadewa; Celine Cornelia; Maula Nuruddin Gaharu; Hamdani, Ismi Adhanisa
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 4 (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.v8i4.969

Background: Brainstem stroke syndrome accounts for 10-15% of all types of strokes, which may result in relatively rare neuroophthalmological manifestations. The aim of this case report is to report findings of one and a half syndrome (OAHS) and internuclear ophthalmoplegia in a patient with brainstem stroke. Case presentation: First case, female, 56 years old, came with sudden weakness on the right side of the body. One and a half syndrome was found, namely when asked to glance to the left, conjugate gaze palsy was obtained horizontally, and when asked to glance to the right, there was adduction inability of the left eye (ipsilateral). Right eye abduction was normal with present nystagmus. Paresis of right central CN. VII, XII was present, along with hemiparesis dextra (contralateral). Head CT scan shows hemorrhage in pons and intraventricular. Second case, female, 65 years old, came with a protruding mouth, vertigo, and sudden double vision Internuclear ophthalmoplegia was present, namely an adduction inability of the left eye (ipsilateral) when asked to glance to the right. Right eye abduction was normal with present nystagmus. no abnormalities were seen in the primary position and when asked to glance to the left. Paresis of right peripheral CN. VII, hemiparesis and right (contralateral) hemihypesthesia was present. MRI shows multiple chronic infarcts as well as subacute infarcts in bilateral parietal and pons. Conclusion: Clinical knowledge is necessary for topic determination, rehabilitation process and evaluation.

One and a Half Syndrome and Internuclear Ophthalmoplegia as Neuro-Ophthalmological Manifestations in Patients with Brainstem Stroke: A Case Series Mahardhika Maghfirani Sadewa; Celine Cornelia; Maula Nuruddin Gaharu; Hamdani, Ismi Adhanisa
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 4 (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.v8i4.969

Background: Brainstem stroke syndrome accounts for 10-15% of all types of strokes, which may result in relatively rare neuroophthalmological manifestations. The aim of this case report is to report findings of one and a half syndrome (OAHS) and internuclear ophthalmoplegia in a patient with brainstem stroke. Case presentation: First case, female, 56 years old, came with sudden weakness on the right side of the body. One and a half syndrome was found, namely when asked to glance to the left, conjugate gaze palsy was obtained horizontally, and when asked to glance to the right, there was adduction inability of the left eye (ipsilateral). Right eye abduction was normal with present nystagmus. Paresis of right central CN. VII, XII was present, along with hemiparesis dextra (contralateral). Head CT scan shows hemorrhage in pons and intraventricular. Second case, female, 65 years old, came with a protruding mouth, vertigo, and sudden double vision Internuclear ophthalmoplegia was present, namely an adduction inability of the left eye (ipsilateral) when asked to glance to the right. Right eye abduction was normal with present nystagmus. no abnormalities were seen in the primary position and when asked to glance to the left. Paresis of right peripheral CN. VII, hemiparesis and right (contralateral) hemihypesthesia was present. MRI shows multiple chronic infarcts as well as subacute infarcts in bilateral parietal and pons. Conclusion: Clinical knowledge is necessary for topic determination, rehabilitation process and evaluation.

LIPOMA INTRAVENTRIKEL DENGAN KADAR TRIGLISERIDA TINGGI SEBAGAI PENYEBAB NYERI KEPALA SEKUNDER : SEBUAH LAPORAN KASUS Maurika, Elisya Shafa Ananda; Adhanisa, Ismi; Mumaiyyizah, Shofiatul; Sasongko, Hari Andang; Gaharu, Maula Nuruddin; Agustina, Lydia; Wati, Djung Lilya
PREPOTIF : JURNAL KESEHATAN MASYARAKAT Vol. 9 No. 3 (2025): DESEMBER 2025
Publisher : Universitas Pahlawan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/prepotif.v9i3.51990

Lipoma intraventrikular merupakan lesi intrakranial jinak yang jarang ditemukan dan umumnya asimtomatik, namun dapat menimbulkan gejala neurologis bila disertai faktor risiko metabolik seperti dislipidemia. Seorang laki-laki berusia 35 tahun datang dengan nyeri kepala kronis non-pulsatil dengan NRS 6 sejak tiga bulan, tidak membaik dengan terapi konservatif, serta memiliki riwayat konsumsi makanan tinggi lemak dan keluarga dengan dislipidemia. Tekanan darah 160/100 mmHg, pemeriksaan fisik umum dan status neurologi dalam batas normal, dan pemeriksaan laboratorium menunjukkan hipertrigliseridemia berat (2410 mg/dL). Berdasarkan panduan ICHD-3, pasien memenuhi kriteria chronic tension-type headache, serta terdapat sefalgia sekunder terkait hipertensi dan hipertrigliseridemia, disertai lipoma intraventrikular. Pemeriksaan MRI kepala memperlihatkan lesi berdensitas lemak konsisten dengan lipoma intraventrikular pada ventrikel lateralis kanan (8,2 × 6,2 mm) dan ventrikel ketiga (8,3 × 16,6 mm). Pasien diberikan fenofibrate 600 mg dua kali sehari dan terapi simptomatik berupa parasetamol 1000 mg dua kali sehari eperisone 50 mg dua kali sehari. Didapatkan perbaikan klinis nyeri kepala menjadi NRS 2, tekanan darah 120/80, disertai penurunan kadar trigliserida menjadi 110 mg/dL dicapai setelah terapi.

ERECTOR SPINAE PLANE BLOCK AS A RESCUE THERAPY IN CHRONIC POSTHERPETIC NEURALGIA: A CASE REPORT Anto, Lie; Ismi A. Hamdani; Irma Savitri; Tiara Aninditha; Nurul Fadli; Yusak Mangara Tua Siahaan; Dyah Tunjungsari; Henry Riyanto Sofyan
Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Vol. 13 No. 1 (2026): 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/aby7m369

Postherpetic Neuralgia (PHN) is a persistent neuropathic pain following Herpes Zoster, particularly in the elderly. A case is reported of a 70-year-old man with PHN two months after HZ, experiencing burning and throbbing pain in the right T11–12 thoracic dermatomes with a pain scale of 8/10, paroxysmal in nature up to 10 times/day, triggered by touch, and disturbing sleep. The pain was unresponsive to gabapentin 1,800 mg/day and amitriptyline 12.5 mg/day. Two perineural injections of 5% dextrose reduced the pain to 6/10. At week 13, an ultrasound-guided erector spinae plane block was performed at the T12 level using 2% lidocaine (10 mL) and dexamethasone 5 mg, which rapidly reduced the pain from 6/10 to 0/10, with sustained improvement and discontinuation of medication. No complications were found. This case shows the erector spinae plane block as a safe, minimally invasive, and effective rescue therapy for refractory PHN.

BACK PAIN IN PARKINSONISM: EXPLORING PAIN GENERATORS AND INTERVENTIONAL MANAGEMENT: A CASE SERIES Hamdani, Ismi; Lie Anto; Irma Savitri; Tiara Aninditha; Nurul Fadli; Yusak Mangara Tua Siahaan; Dyah Tunjungsari; Henry Riyanto Sofyan
Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Vol. 13 No. 1 (2026): 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/kfdtz052

Pain is a common non-motor symptom in parkinsonism, often overlooked despite its significant clinical impact. The most common form is Parkinson's disease (PD), followed by secondary and atypical parkinsonisms such as PSP. Two cases presented with musculoskeletal-spinal pain as the chief complaint: a PD patient with upper back pain that improved after an erector spinae nerve block, and a PSP patient with lumbar facet pain that improved after an intra-articular steroid injection. Pain in parkinsonism can originate from muscles, bones, joints, discs, ligaments, fascia, or nerves, requiring careful evaluation. Both cases demonstrate the effectiveness of pain injection interventions in patients unresponsive to conservative therapy. Appropriate pain assessment and management are crucial to improving the quality of life of parkinsonism patients.

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