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Rivan Danuaji
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Departement of Neurology, Faculty of Medicine Universitas Sebelas Maret, Surakarta, Indonesia Jl. Kol. Sutarto No. 132 Surakarta, Indonesia
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Magna Neurologica
Published by Universitas Sebelas Maret
ISSN : 29636027     EISSN : 29853729     DOI : https://doi.org/10.20961/magnaneurologica.v1i2.647
Core Subject : Health, Science,
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health
Magna Neurologica is a peer-reviewed and open access journal that focuses on promoting neurological sciences generated from basic neurosciences and clinical neurology. This journal publishes original articles, reviews, and also interesting case reports. Brief communications containing short features of medicine, latest developments in diagnostic procedures of neurology disease, treatment, or other health issues related to neurology that is important also acceptable. Letters and commentaries of our published articles are welcomed.
Arjuna Subject : Kedokteran - Neurologi Klinis
Articles 8 Documents
 1 
Search results for , issue "Vol. 2 No. 1 (2024): January" : 8 Documents clear
The Effect of Levofloxacin Addition on the Outcome of Tuberculous Meningitis Patients: A Systematic Review and Meta-analysis Damastiwi, Lorisna Hardiknastia; Hidayat, Saiful; Sembiring, Paulus Stephen Pulung Aditya Nugraha
Magna Neurologica Vol. 2 No. 1 (2024): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v2i1.890

Abstract

Background: Tuberculous meningitis (TBM) is one of tuberculosis's deadliest extra-pulmonary manifestations. Although early initiation of anti-tuberculosis drugs can reduce mortality and morbidity, poor blood-brain barrier penetration hampered their effectiveness. Levofloxacin is an anti-tuberculosis drug with good BBB penetration. Objective: We aim to explore whether levofloxacin addition to the TBM patients’ regimen has a potential benefit to improve their outcomes. Methods: The literature search was done on PubMed, Google Scholar, and ProQuest databases without publication date limits to identify studies investigating the effect of augmenting levofloxacin in the outcome of TBM patients. The primary outcome of this study was to analyze the impact of these regimens in decreasing the risk of death and neurological deficit. The articles were collected using the PRISMA diagram, critically appraised using PICO analysis, then the data were analyzed using Review Manager 5.4.1 software with a Fixed Effect Model. The results were expressed as odds ratio (OR). Results: Four randomized controlled trials with a total of 930 patients were identified. Two trials compared the effectiveness of levofloxacin addition only, whereas the other two used the regimen containing the increased dose of rifampicin alongside levofloxacin addition. Based on the analysis, neither levofloxacin addition only nor increasing rifampicin dose with levofloxacin addition had a significant impact on the mortality of TBM patients (OR=0.55; 95% CI 0.19-1.59; p=0.27, OR=1.01; 95% CI 0.74-1.36; p=0.97, respectively). Conclusion: Additional Levofloxacin on TBM treatment shows no significant improvement in patient mortality. Routine levofloxacin use in TBM is discouraged due to limited evidence.
Patient with Foreign Accent Syndrome in Post Infarct Thrombotic Stroke: A Case Report Tiffany, Firstiafina; Ristinawati, Ira; Nur Hanifa, Shafira
Magna Neurologica Vol. 2 No. 1 (2024): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v2i1.894

Abstract

Background: Stroke is the second leading cause of death in the world and is the leading cause of disability worldwide. One of the disabilities is language disorder. Foreign Accent Syndrome (FAS) is a clinical condition associated with a noticeable change of accent, that could affect verbal communication and social interaction skills. By identifying this case earlier, we hope that the patient’s activity daily living is less disrupted. Case: A 54-year-old woman presented with right limb weakness and tingling, along with a change in speech accent from Javanese to Madurese, despite no prior exposure to Madurese. Neurobehavioral examination revealed language and memory disturbances, and MRI showed cerebral infarction in the bilateral hippocampi, small vessel ischemia in the bilateral frontal lobes, and corona radiata. Discussion: The accent change, known as FAS that was experienced by the patients are thought to be due to neurological causes, which was stoke. In a study using a lesion network mapping approach concluded that the lesion causing accent disorder was located within a single network in the bilateral frontal lobe. In line with the existing theory, the MRI results in this patient showed ischemia in the blood vessels of the bilateral frontal lobes. Conclusion: Clinical symtoms related to stroke depending on the location of the lesion. The accent change in this patient, known as Foreign Accent Syndrome (FAS), is believed to be caused by stroke affecting the bilateral frontal lobes. Early recognition of FAS can help reduce disruptions in communication and social interactions.
Cerebral Proliferative Angiopathy as the Cause of Symptomatic Epilepsy in a Young Adult Male: A First Case Report from Indonesia Swatan, Jovian Philip; Sani, Achmad Firdaus; Islamiyah, Wardah Rahmatul; Kurniawan, Dedy; Fatimah, Ersifa
Magna Neurologica Vol. 2 No. 1 (2024): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v2i1.895

Abstract

Background: Cerebral proliferative angiopathy (CPA) is a rare and distinct vascular malformation that was once considered a subset of cerebral arteriovenous malformation (AVM). Due to its relatively benign course with no distinctive clinical feature, CPA may often be overlooked and misdiagnosed with other diseases. We would like to report a case of CPA as the underlying cause of symptomatic epilepsy. Case: A 31-year-old male presented to the outpatient clinic with a history of focal to bilateral tonic-clonic seizure for 2 years. Following conservative management with an oral antiepileptic agent, the seizure frequency significantly decreased from once daily to once or twice monthly. The patient was lost to follow-up; however, he was incidentally referred back to our clinic two years later for further evaluation. A head Magnetic Resonance Imaging and Magnetic Resonance Angiography revealed a suspicion of giant AVM in the left hemisphere. Cerebral digital subtraction angiography (DSA) was performed and revealed a CPA in the left frontal area. The patient was managed conservatively, and during the 6-month follow-up period, the patient did not have any seizures. Discussion: In young adults, seizures may be caused by an underlying vascular abnormality. Cerebral DSA remained the gold standard for distinguishing various etiologies of vascular malformation, including CPA. Conclusion: Conservative treatment using oral antiepileptic agents was effective in controlling the seizure frequency in CPA. However, a complete diagnostic evaluation is still warranted to determine the most appropriate treatment while revealing some peculiar and unexpected etiologies in the process.
A Life-Threatening Neurotoxicity in Bungarus Candidus Snake Bite: A Case Report Putra, Zaki Rusmana; Anthoni, Togar; Budiharto, Chris Eko
Magna Neurologica Vol. 2 No. 1 (2024): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v2i1.903

Abstract

Background: Bungarus Candidus is a snake that induces severe neurotoxic symptoms. Case: A 31-year-old female came to the emergency department with complaints of pain in the whole body, limb weakness, shortness of breath, and epigastric pain after being bitten by a snake. Neurological examination, ptosis of both eyelids was found with normal movement of the eyeballs. Muscle strength in all extremities is 4, followed by decreased physiological reflexes. There are fang marks in the form of 2 slightly swollen and reddened black dots on the left foot. During observation, the patient had decreased consciousness and severe shortness of breath with desaturation without any signs of shock. Other clinical revealed bilateral dilated pupils, dysphonia, dysarthria, and muscle strength that was difficult to assess. The patient was intubated and subsequently admitted to the ICU. The patient regained consciousness but still had difficulty opening his eyes and weak muscle strength on the 2nd of ICU. The patient's condition improved on the 5th of ICU, extubating was performed and transferred to the non-ICU. The treatment obtained included 17 vials of SABU, analgesics, antibiotics, anticholinesterase, and anticholinergic. The patient was discharged after 11 days of hospitalization. Discussion: The neurotoxicity of snake venom is related to mechanisms of neuromuscular transmission blockade, pre-synaptic and post-synaptic. Bungarus Candidus has a peculiar type of toxin, candoxin, that inhibits nicotinic acetylcholine receptors at the postsynaptic site. Conclusion: Prompt recognition of symptoms and management interventions in snakebite cases are critical to patient outcomes and survival.
The Correlation Between the Number of Vascular Risk Factors and The Onset of Hemodialysis with Cognitive Impairement in Chronic Kidney Disease (CKD) Patients Utami, Priyanka Ganesa; Sundawiyani, Wiwin
Magna Neurologica Vol. 2 No. 1 (2024): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v2i1.904

Abstract

Background: Cognitive impairment is a common disorder in patients with chronic kidney disease (CKD). At least, 50% of CKD patients experience impaired cognitive function caused by ischemia associated with impaired vascular function. In addition, significant changes during the dialysis process such as loss of water and ultrafiltration will disrupt the blood supply to the brain and exacerbate ischemia that underlies the incidence of impaired cognitive function. Objective: Analyze the correlation between vascular risk factors, dialysis onset, and cognitive impairment in CKD patients. Methods: This analytic observational study sampled CKD patients on hemodialysis between February-July 2023, using purposive sampling. Inclusion and exclusion criteria were applied, and cognitive function was assessed using MOCA-INA. Spearman's rho statistical analysis was employed at a 95% confidence level (p <0.05). Results: The results of correlation test using Spearman Rho showed patients undergoing hemodialysis for more than 5 years had a correlation with impaired cognitive function, P=0.02. Cognitive domains that are most affected sequentially are memory/delayed recall, visuospatial, abstraction, language, attention and naming. While the number of vascular risk factors did not have a correlation with cognitive impairment with P=1.38. Conclusion: CKD patients on hemodialysis for more than 5 years show a correlation with impaired cognitive function, primarily affecting memory/delayed recall, visuospatial, abstraction, language, attention, and naming. Vascular risk factors, however, exhibit no correlation with cognitive impairment.
Diabetes Mellitus and Hypertension are Associated with Bell's Palsy Romadhoni; Herianti, Silva Optalmi; Yekti, Murwani; Khamsiyati, Siti Istiqomah
Magna Neurologica Vol. 2 No. 1 (2024): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v2i1.908

Abstract

Background: Bell's palsy occurs in approximately 40-70% of all cases of acute peripheral facial nerve paralysis, and its cause is unknown. Bell's palsy has several risk factors, including diabetes mellitus and hypertension. Objective: This study aims to identify the association between diabetes mellitus and hypertension with the occurrence of Bell's palsy. Methods: This research was conducted at RSUD Tugurejo Semarang in March 2022 using a retrospective study design and purposive sampling technique. Data collected included the history of diabetes mellitus, hypertension, and the occurrence of Bell's palsy. Medical records were used as research instruments. Hypothesis testing was performed using the Fischer exact test. Results: A total of 32 samples were included in this study. There were 11 patients (34.4%) with a history of diabetes mellitus, 21 patients (65.6%) with a history of hypertension, 11 patients experienced acute Bell's palsy (34.4%), and 21 patients had subacute Bell's palsy (65.6%). The statistical analysis showed a significant association between diabetes mellitus (p=0.017) and hypertension (p=0.033) with the occurrence of Bell's palsy. Conclusion: This study reveals a significant correlation between diabetes mellitus and hypertension and the occurrence of Bell's palsy. Several studies also suggest that hypertension is linked to a poorer prognosis in patients with comorbidities and facial paralysis in Bell's palsy. However, there are also studies stating that age and gender are associated with the occurrence of Bell's palsy independently of diabetes and hypertension.
Efficacy of Repetitive Transcranial Magnetic Stimulation (r-TMS) Therapy on Improving Motor Strength in Stroke Patients at Dr. Moewardi Surakarta Revianto, Ari; Hambarsari, Yetty
Magna Neurologica Vol. 2 No. 1 (2024): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v2i1.940

Abstract

Background: Stroke, an acute neurological dysfunction, poses a health challenge with a potential fatality, emerging as a leading cause of long-term disability. This study explores the efficacy of repetitive transcranial magnetic stimulation (r-TMS) with medical rehabilitation in enhancing stroke patients' motor strength, comparing it with standard therapy and focusing on the Medical Research Council score. Objective: Stroke is an acute manifestation resulting from neurological dysfunction, persisting for ≥24 hours or leading to death due to blood vessel disorders. The study aims to determine the effectiveness of r-TMS therapy in improving stroke patients' motor strength, comparing it with standard therapy based on the Medical Research Council score. Methods: A quasi-experimental study with a pre-post control group design involved 30 respondents selected through consecutive sampling in stroke units and outpatient clinics. Upper extremity muscle strength, measured with the Medical Research Council score, was analyzed using the Mann-Whitney U test, with a significance level set at p < 0.05. Results: The post-test ranking value of the r-TMS group (20.56) exceeded that of the Non r-TMS group (10.46). The Mann-Whitney U test indicated a significant difference in the average ranking of the Medical Research Council scores between the two groups (p < 0.05, 0.001), highlighting the efficacy of r-TMS therapy in enhancing motor strength. Conclusion: This study shows that stroke patients receiving standard therapy and transcranial magnetic stimulation exhibit improvements in extremity motor strength compared to those undergoing medical rehabilitation alone. The r-TMS group notably showed a significant increase in extremity motor strength.
The Effectiveness of Transcranial Magnetic Stimulation in Post Stroke Dysphagia: A Case Report Ginting, Suska Lara; Hambarsari, Yetty; Danuaji, Rivan; Hamidi, Baarid Luqman
Magna Neurologica Vol. 2 No. 1 (2024): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v2i1.942

Abstract

Background: A 72-year-old male, experiencing dysphagia and left-sided weakness for six months post-stroke, encountered challenges such as coughing and choking during the consumption of liquids and soft foods, along with a prolonged meal-swallowing process. Magnetic Resonance Imaging (MRI) revealed bilateral thrombotic infarction and left lateralization. Case: The Gugging Swallowing Screening Scale (GUSS) assessment demonstrated severe impairment with a total score of 7, persisting despite conventional physiotherapy attempts to improve swallowing function. Subsequently, repetitive transcranial magnetic stimulation (rTMS) was implemented, involving high-intensity stimulation in the ipsilesional hemisphere and low-intensity stimulation in the contralesional hemisphere. Remarkably, one-month post-rTMS, the patient displayed significant progress, evidenced by an improved GUSS score of 15, indicating enhanced swallowing function. Discussion: This case emphasizes the positive impact of bilateral rTMS hemispheric stimulation on post-stroke dysphagia. The strategic application of high-intensity ipsilesional and low-intensity contralesional stimulation emerged as an effective intervention for alleviating swallowing difficulties. Conclusion: These findings highlight the potential of rTMS as an innovative therapeutic approach for persistent dysphagia following a stroke. Repetitive transcranial magnetic stimulation (rTMS) has shown significant potential as an innovative and effective therapeutic approach for managing persistent post-stroke dysphagia. This case highlights the role of tailored rTMS protocols in improving swallowing function, with recovery influenced by factors such as stroke severity, dysphagia severity, age, nutritional status, timing of intervention, and lesion location.

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