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Jurnal Sinaps
Published by Universitas Sam Ratulangi
ISSN : 26152002     EISSN : 26152002     DOI : -
Core Subject : Health, Science, Education,
Education Neuroscience Public Health
Sinaps: Jurnal Neurologi Manado (Nomor ISSN online 2615-2002)adalah Jurnal terbitan dari Perhimpunan Dokter Spesialis Saraf Cabang Manado dan Bagian/KSM Neurologi FK Unsrat/RSUP Prof. Dr. R.D Kandou Manado
Arjuna Subject : Ilmu Syaraf - Neorologi
Articles 85 Documents
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DIAGNOSIS DAN TATALAKSANA SINDROM NYERI MYOFASIAL Stella; Sekplin A. S. Sekeon; Melke J. Tumboimbela
Jurnal Sinaps Vol. 4 No. 1 (2021): Volume 4 Nomor 1, Februari 2021
Publisher : Neurologi Manado

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Abstract

Myofascial pain syndrome is characterized by regional pain originating from hyperirritable spots located within taut bands of skeletal muscle, known as palpable myofascial trigger points (MTrPs).1,2,3 It affects a majority of the general population, impairs mobility, causes pain, and reduces the overall sense of well-being4.Reliably establishing the prevalence of MPS proves to be challenging, as there are no widely accepted diagnostic criteria.5 Trigger points are thought to occur as a result of muscle overuse ormuscle trauma or psychological stress. Myofascial pain syndrome is collection of the sensory, motor, and autonomic symptoms that include local and referred pain, decreased range of motion, and weaknes4.The reliability of MTrP diagnosis has long been a debatable point in the medical literature, because there had been no laboratory or imaging technique that was capable of confirming the clinical diagnosis.3 A careful history and physical exam remain the cor­nerstone of effective diagnosis5. Reating the underlying etiology is currently the most widely accepted strategy for MPS therapy. If the root cause is not properly treated, MTrPs may reactivate and MPS may persist.1 Various methods of MTrP treatment are available but there are currently no clinical guidelines so clinicians are required to balance the evidence, their clinical experience and the patient’s preferences.6
MIELITIS LUPUS SEBAGAI MANIFESTASI AWAL LUPUS ERITEMATOSUS SISTEMIK: LAPORAN KASUS Erwin Widi Nugraha; Arthur H.P. Mawuntu; Riwanti Estiasari
Jurnal Sinaps Vol. 4 No. 1 (2021): Volume 4 Nomor 1, Februari 2021
Publisher : Neurologi Manado

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Abstract

Background: Lupus myelitis is one of 19 neuropsychiatric syndromes related to systemic lupus erythemathosus (SLE) defined by American College of Rheumatology (ACR) as neuro-psychiatric SLE (NPLSE). Lupus myelitis is one of the least common NPSLE with an incidence between 1-2% in the SLE population, however is generally severe. Almost 50% of cases of lupus myelitis are presented as the initial manifestation of SLE and about two-third is associated with high lupus activity. Case report: Twenty-three-year-old man presented with the only symptom of dysesthesia at epigastric and back region (T7 dermatome) with a sensation of tight band-like pain. Neurological examination revealed positive finger escape test and Hoffman-Tromner reflex on both hands, slight lower extremities weakness as demonstrated from repetitive squatting and tip-toe walking tests, and positive Lhermitte test. The whole non-contrast spine MRI found multiple short segment T2 hyperintensities on spinal cord level C6-C7 and T3-T5. The brain MRI result was unremarkable. The cerebrospinal fluid analysis only found a slight increase in protein level (50mg/dl). Laboratory results showed a positive anti-Smith (Sm) antibody and low level of vitamin D 25-OH total (20,6ng/ml). The patient was diagnosed with SLE and lupus myelitis. His lupus myelitis was presented as the initial and the only clinical manifestation of SLE. The heterogeneity of clinical manifestations of lupus myelitis poses a challenge in diagnosing this disorder, therefore immunological screening for SLE is essential and recommended in cases of myelitis.
DIAGNOSIS DAN TATALAKSANA CEDERA MEDULA SPINALIS TRAUMATIK Andika Surya Atmadja; Sekplin A. S. Sekeon; Denny J. Ngantung
Jurnal Sinaps Vol. 4 No. 1 (2021): Volume 4 Nomor 1, Februari 2021
Publisher : Neurologi Manado

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Abstract

Traumatic spinal cord injury is a trauma that affect spinal cord and or another structures around it that made temporary or permanent changes in motoric, sensory and or autonomic function. Around 15% patient with traumatic head injury also had spinal cord injury (SCI). Also, around 25% patient with SCI also had head injury. Around 55% SCI occur in cervical, 15% in thoracal, 15% in thoracolumbal, and 15% in thoracosacral. It have to be remembered that SCI could occur multiple. Around 10% patient with fracture in vertebrae cervical also had vertebral fracture in another segment. Management in SCI should be started from the accident place. It needs a right immobilization and transfer technique. Around 3-25% SCI happen after the first trauma, like in the first management or transportation. SCI patient need imaging. The Joint Section on Disorder of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons divide the patient’s condition into 3 categories, the patient without symptom and fully alert, patient with symptom and fully alert, and unconscious patient. This imaging decision is based on National Emergency X-Radiography Utilization Study Group (NEXUS). The usage methylprednisolone according to NASCIS had some controversies. Operative treatment is aimed to decompression, repair the deformity, and stabilize the vertebrae. In acute phase, operation aim to reduce compression in spinal cord and ischemic so it could make an optimal condition for neurological restoration.
INDONESIAN VERSION OF THE PAINDETECT QUESTIONNAIRE IN THE ASSESSMENT OF NEUROPATHIC PAIN: A VALIDITY AND RELIABILITY STUDY Karolina Margareta; Manfaluthy Hakim; Mohammad Kurniawan; Tiara Anindhita; Herqutanto
Jurnal Sinaps Vol. 4 No. 2 (2021): Volume 4 Nomor 2, Juni 2021
Publisher : Neurologi Manado

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Abstract

Objective: To develop an Indonesian version of PainDETECT Questionnaire (PDQ-Ina) and assess itsvalidity and reliability. Methode: The validity and reliability study was conducted at the Neurology ClinicCipto Mangunkusumo General Hospital, Jakarta from March 2014 until May 2014 using cross sectionaldesign. Sample of the research was done by non random consecutive sampling method. and were takenfrom each participant who met the inclusion criteria, measuring reliability of painDETECT Questionnaires(PDQ) using statistical analysis and retest test method within 24-48 hours interval. Result:There were150 subjects with chronic pain. Divided in to 3 types of group based on Indonesian version PDQ scoring,75 patients having nociceptive pain, 42 were mixed pain and 33 patients having neuropathic pain. Withinvalidation criteria analysis there were high correlation between PDQ-Ina with LANSS instrument as goldstandard (r= 0,082,p<0,001), AUC 85,5%, sensitivity 78,3% and specificity 78,7% with the optimal cut offpoint ≥17. The reliability of internal consistency Cronbach’s Alpha value were 0,710 and the test retestrealibility were 0,96. Conclusion :The Indonesian version of the PDQ is a valid and reliable scale andhave a good sensitivity and specificity to be used to determine neuropathic component of chronic pain.
LITERATURE REVIEW: NEUROLOGICAL ASPECT OF CORONAVIRUS DISEASE 2019 (COVID-19): PART I. OVERVIEW AND PATHOMECHANISM Arthur H.P Mawuntu; Devina C Mastari; Albertus T Lapian; Agnes K.S Hermawan; Mieke A.H.N Kembuan
Jurnal Sinaps Vol. 4 No. 2 (2021): Volume 4 Nomor 2, Juni 2021
Publisher : Neurologi Manado

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Abstract

Since coronavirus disease 2019 (COVID-19) was first reported in China in December 2019, this diseasehas caused a world health crisis and has attracted enormous research interest. The emergence ofneurological manifestations has prompted efforts to understand the COVID-19 pathomechanismsassociated with the nervous system through various studies. This paper discusses the neurological aspectsrelated to COVID-19 infection and neuroinvasion including the underlying mechanisms. Other issuesdiscussed in other parts were clinical manifestations especially associated with neurological aspect, druginteractions as well as disease effects in neurology patients. Understanding this may help manage thepatient.
LITERATURE REVIEW: NEUROLOGICAL ASPECT OF CORONAVIRUS DISEASE 2019 (COVID-19): PART II. CLINICAL MANIFESTATIONS AND DRUG INTERACTIONS Arthur H.P Mawuntu; Devina C Mastari; Albertus T Lapian; Agnes K.S. Hermawan; Mieke A.H.N Kembuan
Jurnal Sinaps Vol. 4 No. 2 (2021): Volume 4 Nomor 2, Juni 2021
Publisher : Neurologi Manado

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Abstract

Coronavirus disease 2019 (COVID-19) was first reported in China in December 2019. This novelvirus has caused a world health crisis with various clinical manifestations. Although the commonmanifestations of COVID-19 infection are fever, cough, malaise, and respiratory problems, there areincreasing reports of clinical manifestations and neurological complications such as decreasedconsciousness, headache, anosmia, stroke, seizures, polyneuropathy, and myopathy. The emergenceof neurological manifestations has prompted efforts to understand the COVID-19 therapies and thepotential drug interactions. Other issues discussed in other parts were pathomechanisms, druginteractions as well as disease effects in neurology patients. Understanding this may help manage thepatient
LITERATURE REVIEW: NEUROLOGICAL ASPECT OF CORONAVIRUS DISEASE 2019 (COVID-19): PART III. NEUROLOGICAL COMPLICATIONS Arthur H.P. Mawuntu; Devina C Mastari; Albertus T. Lapian; Agnes K.S. Hermawan; Mieke A.H.N. Kembuan
Jurnal Sinaps Vol. 4 No. 2 (2021): Volume 4 Nomor 2, Juni 2021
Publisher : Neurologi Manado

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Abstract

Coronavirus disease 2019 (COVID-19) not only has common manifestations of COVID-19 infection arefever, cough, malaise, and respiratory problems, but also neurological manifestations such as decreasedconsciousness, headache, anosmia, stroke, seizures, polyneuropathy, and myopathy. These neurologicalmanifestations support other serious neurological complications found in patients with COVID-19 andsimilar coronaviruss, severe acute respiratory syndrome (SARS-CoV-1) and Middle East respiratorysyndrome (MRS-CoV). This paper discusses the neurological aspects related to COVID-19 infection,neurological complication and high-risk neurology patients. Issues discussed in other parts werepathomechanism, clinical manifestations, and drug interactions Understanding this may help manage thepatient
NEUROLOGICAL DISORDERS IN GLAUCOMA Siti Hajar; Dessy Rakhmawati Emril; Firjatullah; Rizkidawati
Jurnal Sinaps Vol. 4 No. 1 (2021): Volume 4 Nomor 1, Februari 2021
Publisher : Neurologi Manado

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Abstract

Glaucoma is a disease of the visual system that causes permanent blindness. Glaucoma is characterized by degeneration of the trabecular meshwork (TM) (the filter responsible for drainage of aqueous humor from the anterior chamber of the eye), which increases intraocular pressure (IOP). Visual manifestations are first peripheral and then central. Current treatment is primarily aimed at lowering IOP. Currently, IOP is considered only one of the risk factors, and even with a normal IOP, glaucoma can occur. Glaucoma is a multifactorial optic neuropathy characterized by progressive destruction of retinal ganglion cells and their axons characterized by progressive structural loss of retinal ganglion cells (RGCs) and loss of vision. Muller cells play a key role in the maintenance of retinal ganglion cell bodies in the retina. Ganglion cell death in glaucoma is mainly caused by apoptosis which is influenced by various factors that have been identified such as genetic, neurotrophic, autoimmune, and excitotoxic.
TOTAL OCCLUSION IN THE LEFT SUBCLAVIAN ARTERY LEADING TO SUBCLAVIAN STEAL SYNDROME IN A MIDDLE AGED MAN Gilbert Tangkudung; Marcelle Yulianne
Jurnal Sinaps Vol. 4 No. 3 (2021): Volume 4 Nomor 3, September 2021
Publisher : Neurologi Manado

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Abstract

Background: Subclavian steal syndrome is the manifestation of subclavian steal phenomenon. Clinical manifestations include vertebra-basilar signs such as vertigo, dizziness, ataxia, dysarthria, and syncope. Recurrent weakness on the left hand is also a common manifestation. Treatment includes conservative approach for mild case. Invasive treatments includes stenting and angioplasty are reserved for highly symptomatic case. Case: Male, 48 years old, presented with recurrent TIA in a form of weakness of left extremities preceded spinning sensation occurred five times a day. Blood pressure examination on right and left arm showed a difference of 20mmHg in systolic blood pressure. Patient had a history of hypertension and was also a smoker. Head MRI examination revealed multiple infarctions. Cerebral angiography revealed a total occlusion of left subclavian artery indicated a subclavian steal phenomenon. Patient was treated with pharmacological therapy and lifestyle modifications. These approach resulted in improvement of the symptoms.Conclusion: Subclavian steal syndrome is a rare case. It is important to consider this diagnosis on patient with recurrent vertebro-basilar manifestations or TIA. Severity of symptoms determines treatment approach.
ISCHEMIC STROKE ANTERIOR AND POSTERIOR CIRCULATION : CHARACTERISTIC COMPARISON AND RISK FACTORS IN KANDOU CENTRAL HOSPITAL MANADO PATIENTS Andika Surya Atmadja; Hugo Dwiputra; Mieke A.H.N Kembuan; Finny Warouw
Jurnal Sinaps Vol. 4 No. 1 (2021): Volume 4 Nomor 1, Februari 2021
Publisher : Neurologi Manado

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Abstract

Background: Ischemic stroke occurs more frequent in anterior than posterior circulation. Ischemic stroke has some risk factors, but the difference between anterior and posterior circulation risk factors still lack of study. Methods: This study was performed in Kandou Central Hospital Manado by collecting the data retrospectively during year 2020. The data was classified to ischemic stroke anterior or posterior circulation. We also collect the patient’s data include gender, age, smoking habit, and also performed physical and supporting examination. Result: There was 100 patients with ischemic stroke anterior circulation and 21 patients with ischemic stroke posterior circulation. The mean age of both group was same (60 years old), but posterior circulation has a wider range of age. Ischemic stroke anterior circulation was more common in man, while posterior circulation was more common in woman. Our data shows 42% ischemic stroke anterior circulation and 33,3% ischemic stroke posterior circulation patients are smoker. The most common risk factor for both group was same, that was hypertension and the second most common was high LDL level. The most frequent heart disease in stroke was arrythmia especially in anterior circulation. Discussion: Ischemic stroke was more frequent in anterior circulation. There was no different in patients characteristics between these two groups. The most common risk factors in both groups was hypertension, and the second most frequent was high LDL level. The most frequent heart disease in stroke patient was arrythmia, especially in anterior circulation. There was no significant differences by statistic between ischemic stroke between anterior and posterior circulation.

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