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All Journal Medicinus : Jurnal Kedokteran Acta Neurologica Indonesia
Djuanda, Gerald
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Medicine & Pharmacology Neuroscience Public Health

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Factors Affecting Progonosis in Tuberculous Meningoencephalitis Puspitasari, Vivien; Sutanto, Anyeliria; Stevano, Reza; Djuanda, Gerald
Acta Neurologica Indonesia Vol. 1 No. 01 (2023): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v1i01.7

Abstract

Introduction: Cases of tuberculosis is still highly prevalent in the world, including Indonesia.Tuberculous meningoencephalitis (TBME) is the most severe form of tuberculosis. This study aims to establish the factors affecting prognosis in TBME. Objective: To Identify the clinical factors that affect the prognosis of tuberculous meningoencephalitis patients. Material and Methods: This is cross-sectional study evaluating factors (clinical features, imaging, and treatment) affecting prognosis in TBME patients who underwent treatment in Siloam Hospitals Lippo Village. Univariate analyses was done, followed by bivariate analyses with logistic regression to compare factors between good (Glasgow outcome scale [GOS] 4-5) and poor (GOS 1-3) prognosis. Results and Discussion: 64 patients were included. On univariate analysis, significant differences was found between Glasgow coma scale (GCS) scores (p=0.012), clinical features of meningeal irritation (p=0.004), findings of hydrocephalus (p=0.023) and vasculitis/infarction (p=0.020) on imaging, antibiotic use (p=0.013), and MRC grading (p=0.008). On logistic regression, 4 factors were found to be significant: headache (OR 5.398 95% CI 1.165-25.008, p=0.031), meningeal irritation (OR 0.146 95% CI 0.026-0.813, p=0.028), hydrocephalus (OR 0.167 95% CI 0.032-0.881, p=0.035), and antibiotic use (OR 0.155 95% CI 0.034-0.717, p=0.017). Conclusion: Clinical manifestations of meningeal irritation and altered consciousness, imaging findings of hydrocephalus and vasculitis/infarction, and antibiotic usage is associated with poor prognosis, while presence of headache is associated with a better prognosis.
A Rare Manifestation of ‘Complex’ Post Streptococcus Infection Movement Disorder in Paediatric Patient a Case Report Lalisang, Lilie; Khairani, Arie; Chairy, Abdul; Djuanda, Gerald
Medicinus Vol. 15 No. 1 (2025): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i1.10769

Abstract

Background: Post Streptococcal Movement Disorder (PSMD) is a rare disease. One of the PSMD diagnosis is Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection (PANDAS). Case Description: 10 year old female with involuntary movement including myoclonic jerks, chorea and stereotype. Movement duration is 5 minutes, repetitive and sensitive to loud noise. Patient has history of respiratory infection 2 weeks ago with Positive ASTO test. Patients showed improvement after treatment with antibiotics, corticosteroids and antipsychotics. Conclusion: The pathophysiology of PANDAS begins with Group A beta-hemolytic infection that causes cross reaction in cortical structures and basal ganglia due to molecular mimicry. Currently there is no definitive test for PANDAS,where diagnosis is primarly confirmed by identifying signs, symptoms and physical neurological examination.
Co-Authors Abdul Chairy, Abdul Khairani, Arie Lalisang, Lilie Stevano, Reza Sutanto, Anyeliria Vivien Puspitasari, Vivien