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All Journal Medicinus : Jurnal Kedokteran eJournal Kedokteran Indonesia Neurona
Sitorus, Freddy
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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MANIFESTASI KLINIS DAN DIAGNOSIS MIGREN VESTIBULAR Sitorus, Freddy; Rida Ariarini, Ni Nengah; Tunjungsari, Dyah
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 35 No 2 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i2.108

Abstract

CLINICAL MANIFESTATION AND DIAGNOSIS OF VESTIBULAR MIGRAINEABSTRACTVestibular migraine (VM) is the most common cause of recurrent spontaneous vertigo on outpatient dizziness clinics. Clinical manifestation of VM is highly variable. Patient may present symptoms like vertigo, dizziness, tinnitus, visual disturbance, phonophobia, photophobia, aural fullness, paresthesia, nausea, and vomiting. Most VM patients have normal physical examination between attacks. Diagnostic criteria of this disease based on joint consensus of the International Headache Society (IHS) together the Barany Society published in 2012. The Differential diagnosis of this disease are benign paroxysmal positional vertigo (BPPV), Meniere’s disease, and acute ischemic attack. Moreover, vestibular migraine treatment is almost the same as for migraine.Keywords: Clinical manifestation, diagnosis, vestibular migraineABSTRAKMigren vestibular (MV) merupakan penyebab tersering vertigo spontan berulang pada pasien di poliklinik spesialis yang menangani rasa goyang. Manifestasi klinis dari migren vestibular sangat bervariasi. Pasien dapat mengeluhkan gejala seperti vertigo, pusing, tinitus, gangguan penglihatan, fonofobia, fotofobia, aural fullness, parestesi, mual, dan muntah. Pemeriksaan fisik pada pasien MV biasanya normal di antara serangan. Penegakan diagnosis penyakit ini berdasarkan konsensus bersama antara International Headache Society (IHS) dan Barany Society pada tahun 2012. Diagnosis diferensial penyakit ini adalah benign paroxysmal positional vertigo (BPPV), penyakit Meniere, dan serangan iskemik akut. Sampai saat ini, terapi untuk migren vestibular hampir sama dengan terapi migren pada umumnya.Kata kunci: Diagnosis, manifestasi klinis, migren vestibular
Neuro-Ophthalmology Manifestations in Brain Tumor Patients and Its Related Factors at dr. Cipto Mangunkusumo Hospital Ariafini, Ni Nengah Rida; Aninditha, Tiara; Sinthia, Novita Ayu; Zairinal , Ramdinal Aviesena; Sitorus, Freddy; Imran, Darma; Prawiroharjo, Pukovisa; Sofyan, Henry Riyanto; Diafiri, Dinda
eJournal Kedokteran Indonesia Vol. 13 No. 1 (2025): Vol 13, No. 1 - April 2025
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

The visual system has complex connections with all brain areas and can be affected by a brain tumor. Neuro-ophthalmological examinations are important because early diagnosis and managing small tumors will improve outcomes. This study aimed to investigate brain tumors' neuro-ophthalmic (NO) manifestation and the affecting factors. A cross-sectional study using total sampling was conducted in patients undergoing pre-operative examinations from January 2014 to December 2019 in dr. Cipto Mangunkusumo National Referral Hospital. Variables studied in this paper are brain tumor characteristics, NO manifestations, and the relationship between them. Analysis was conducted using chi-square or Fisher's exact test and post hoc analysis. All subjects presented with NO manifestations, with fundoscopic abnormalities (72.9%) as the most common manifestation. The relationships between the tumor type with visual field disturbances (p=0.002) and multiple tumor lesions with funduscopic abnormalities (p=0.043) were significant. Lesion location also had a significant relationship with all NO variables (p<0.05). The NO manifestations were found in all subjects, predominantly the fundoscopic abnormalities. The tumor type, number of lesions, and location of lesions had a significant relationship with NO manifestations.
Tuberculoma With Visual and Vestibular Symptoms in A β-Thalassemia Patient: A Case Report Suryawijaya, Evlyne Erlyana; Ariarini, Ni Nengah Rida; Diafiri, Dinda; Dewati, Eva; Sitorus, Freddy
Medicinus Vol. 14 No. 3 (2025): June
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v14i3.10163

Abstract

Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis, which can affect the lungs (pulmonary TB) as well as other organs (extrapulmonary TB), including the central nervous system (CNS). The number of TB cases in Indonesia remains high, with 969,000 cases reported in 2021. Tuberculoma is a manifestation of TB in the CNS, presenting as an intracranial mass due to the spread of TB from other organs. It is a rare and serious form of CNS TB infection. The presence of congenital β-thalassemia adds complexity to the pathogenesis, diagnosis, and treatment of tuberculoma. Case Description: A 25-year-old female with a history of β-thalassemia HbE intermedia with a major phenotype presented with the main complaint of blurred vision in the lower right visual field. The patient also experienced vertigo, headache, and a history of seizures. Examination revealed inferior right quadrantanopia, anemia, leukopenia, and thrombocytopenia. Imaging and CSF analysis supported a diagnosis of intracranial tuberculoma. The patient was treated with anti-TB medication and intravenous dexamethasone. Discussion: Patients with thalassemia may have an increased risk of TB infection, including CNS TB. Tuberculoma involves granuloma formation in the brain, often in the meninges and cerebrum. Its manifestations vary and can include headaches and seizures. Diagnosis is based on clinical history, radiological findings, and laboratory results. The patient’s symptoms and imaging findings supported a diagnosis of tuberculoma, for which anti-TB and neurorestorative therapy was administered. Conclusions: Tuberculoma, as a manifestation of CNS TB, presents with variable and non-specific symptoms. Visual field disturbances can be one of the presenting symptoms that aid in diagnosis. Clinical, radiological, and laboratory evaluations are necessary for prompt and accurate diagnosis. Treatment involves anti-TB therapy and dexamethasone. This case highlights the importance of early diagnosis and comprehensive management of complex extrapulmonary TB infections.
Co-Authors Aninditha, Tiara Ariafini, Ni Nengah Rida Ariarini, Ni Nengah Rida Dewati, Eva Diafiri, Dinda Dyah Tunjungsari, Dyah Imran, Darma Pukovisa Prawiroharjo, Pukovisa Rida Ariarini, Ni Nengah Sinthia, Novita Ayu Sofyan, Henry Riyanto Suryawijaya, Evlyne Erlyana Zairinal , Ramdinal Aviesena