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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 10 Documents
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Search results for , issue "Vol. 3 No. 1 (2025): January" : 10 Documents clear
Management of Preoperative Meningioma Embolisation: First Case Report at Dr Soeradji Tirtonegoro Hospital Klaten Fauzi Novia Isnaening Tyas; Huda Syahdan Al Hadad; Mianoki, Adika
Magna Neurologica Vol. 3 No. 1 (2025): 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.v3i1.909

Abstract

Background: Meningioma is the most common primary central nervous system tumor among benign brain tumors. Clinical manifestations vary based on the tumor's location and size, with some patients being asymptomatic and others experiencing neurological deficits. Symptomatic meningioma patients often undergo surgical management. Preoperative embolization has been shown to reduce surgical complications by minimizing intraoperative bleeding and shortening the procedure's duration. Case: A 47-years-old woman presented with progressive right limb weakness, recurrent headaches, blurred vision, and vomiting over three months, worsening in the past week. Neurological examination revealed XII nerve paresis and limb weakness. Imaging studies identified a sizeable intracranial mass with perilesional edema, leading to a diagnosis of meningioma. The patient underwent preoperative endovascular embolization followed by craniotomy and tumor excision, resulting in a favorable postoperative outcome. Her postoperative course was uneventful, with significant improvement and regular follow-up at Dr. Soeradji Tirtonegoro General Hospital. Discussions: Preoperative embolization is beneficial for selected patients with intracranial meningiomas, especially those with highly vascular tumors. This technique effectively reduces intraoperative bleeding and surgical duration, decreasing the risk of complications. Advances in embolization techniques and materials have significantly improved outcomes and expanded their applicability. Ongoing research continues to refine and optimize meningioma management, enhancing surgical success and patient prognosis. Conclusion: This case demonstrates the effectiveness of preoperative embolization in managing intracranial meningiomas. The technique reduces intraoperative complications and improves postoperative recovery, emphasizing its critical role in optimizing surgical outcomes for meningioma patients.
The Correlation Between Cervical Provocation Tests and Compression Severity in EMG Findings of Cervical Root Syndrome Patients Zahra, Farah Shabri Alifia; Kurniawan, Shahdevi Nandar; Petrarizky, Alfred Julius
Magna Neurologica Vol. 3 No. 1 (2025): 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.v3i1.939

Abstract

Background: Medical professionals are often found using cervical provocation tests and Electromyography (EMG) examination to diagnose Cervical Root Syndrome (CRS). Although EMG examinations are unavailable in primary health care facilities due to the lack of equipment, the results of cervical provocation tests are expected to correlate with the findings of the EMG examination. Objective: This study aimed to investigate the correlation between cervical provocation tests (Lhermitte and Spurling) and compression severity of CRS. Methods: 85 medical records that met the inclusion and exclusion criteria were selected using a stratified random sampling method. Subsequently, cervical provocation tests were scaled ordinal, stratified into negative, positive 1, and positive 2, while compression severity was grouped into mild, moderate, and severe. The data obtained was analyzed using SPSS, and correlation analysis was conducted using the Spearman method. Results: The result showed that cervical provocation tests had a very weak negative correlation with the CRS compression severity, and the values obtained were not statistically significant (R = -0.105 and p = 0.341). Conclusion: The results showed that there was no significant correlation between cervical provocation tests and CRS compression severity. Therefore, cervical provocation tests cannot be depended on as a representation of CRS compression severity.
Rivaroxaban as A Therapy in Cerebral Venous Thrombosis (CVT): A Systematic Review Nafi', Maisan; Permatasari, Agnes Ardelia; Adhitama, Adrianus Setyawan
Magna Neurologica Vol. 3 No. 1 (2025): 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.v3i1.1070

Abstract

Background: Cerebral venous thrombosis (CVT) can be fatal if untreated. The European Stroke Organization recommends Low Molecular Weight Heparin in the acute phase and oral anticoagulants (VKA) for 3-12 months post-acute to prevent recurrence. Rivaroxaban, a Direct Oral Anticoagulant (DOAC) inhibiting factor Xa, is associated with reduced risks of fatal bleeding and intracranial hematoma. This systematic review aims to evaluate the efficacy and safety of Rivaroxaban therapy in CVT patients. Objective: To evaluate the efficacy and safety of Rivaroxaban therapy in patients with cerebral venous thrombosis (CVT), particularly post-acute phase, through a systematic review of relevant studies. Methods: Our review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with an electronic search using PubMed, Cochrane, Sage, Embase, and Ebsco published between 2012 and 2022. This study included patient with CVT above 18 years old, confirmed by radiographic examination. Results: From 339 studies we found, 6 studies were included with 113 participants who completed the research program. Major bleeding was 2.26% (n=3).Venous thromboembolism was 1.7% (n=2). Recurrent CVT was 1.7% (n=2). Score of mRS 0-1 was 76% (n=86), mRS score 2 was 2.6% (n=3) while 21 subject in a study were evaluated with NIHSS. Death was found 1.7% (n=2) which caused still unknown. Recanalization in 6-12 months both partial and complete was reported 66.3% (n=75), no recanalization was 1.7% (n=2), no recanalization evaluation was found 30.9% (n=35). Conclusion: Rivaroxaban appeared to be safe and has good efficacy as a therapy in patient with CVT after acute phase.
A 61-Years-Old Female with Moyamoya Syndrome: A Case Report Savitri, Martha Oktavia Dewi; Fairuzya, Azmi Farah; Subandi; Imanuddin, Iqbal; Romadhoni, Andry Nur Wahyu Putra; Hosoya, Tomohiro
Magna Neurologica Vol. 3 No. 1 (2025): 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.v3i1.1119

Abstract

Background: Moyamoya vasculopathy (MMV), like Moyamoya disease (MMD) and Moyamoya syndrome (MMS), is a rare chronic cerebrovascular angiopathy, especially in elderly patients. The incidence onset of MMV were unique with bimodal peak age: 5-10 years old and 25-49 years old. Case: A 61-year-old-female complaint of sudden onset left-sided hemiparesis one month before admission, headache, and forgetfulness. She had history of diabetes mellitus for 3 years. Neurological physical examination found left hemiparesis with motoric strength 4/5. Laboratory findings are unremarkable. Brain MRI with contrast showed infarcts at subcortical regions. Her cerebral DSA examination suggested diffuse multiple stenosis in the anterior circulation and total occlusion of left external and internal carotid artery. “Puff of smoke” and “champagne-bottle like neck sign” were found in DSA imaging, typical signs of MMD. She received aspirin 80 mg as her secondary prevention of another stroke event.  Discussion: MMV case at elderly onset which is similar to prior small study with mean age of 60 years old. Previous study mentioned hypertension (44%) and diabetes mellitus (16%) were found in older MMD patients. Patient was given aspirin 80mg daily. Precautions in this case include taking lifelong antiplatelet, managing diabetes mellitus, and implementing lifestyle modification. This treatment approach was directed to lower concomitant risk of ischemic stroke. Conclusion: We report a case of MMV which was considered as a rare case and a cause of stroke event. The management of this case was directed to control the coexisting condition of ischemic stroke using antiplatelet drug and risk factor management.
Recurrent Brain Abscess in 40-Years-Old Female Associated with Ventricular Septal Defect: A Case Report Fairuzya, Azmi Farah; Savitri, Martha Oktavia Dewi; Prabaningtyas, Hanindia Riani; Watanabe, Yasuhiro; Murakami, Takenobu; Tajiri, Yuki
Magna Neurologica Vol. 3 No. 1 (2025): 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.v3i1.1123

Abstract

Background: Ventricular septal defect (VSD) is one of the critical risk factors for brain abscess. The unsterile blood in uncontrolled cyanotic congenital heart disease cases will travel to the brain after escaping the filtration mechanism and cause brain abscess. Case: A 40-year-old female presented with a two-week course of moderate headaches, worsening severely four days before admission. Neurological manifestations included attention deficits, dysarthria, right-sided hemiparesis, and proper facial palsy. Laboratory findings indicated leukocytosis and polycythemia. Echocardiography revealed VSD. Brain MRI with contrast suggested a single abscess lesion in the left occipital lobe. A histopathological examination confirmed the diagnosis. Antibiotics were administered during hospitalization, with outpatient treatment afterward. A one-month follow-up revealed new symptoms and a subsequent surgical excision. Discussion: Brain abscess remains a challenging and life-threatening case despite advanced diagnostic techniques. Uncontrolled cyanotic heart disease might be an essential risk factor for brain abscess occurrence. Thorough diagnostic examinations must be conducted to establish the diagnosis. The optimal empirical-targeted antibiotic treatment is a cornerstone of management. After antibiotic therapy, a surgical approach must be considered in lesions with large-size or nonoptimal size reduction. It is essential to comprehensively manage brain abscesses and their etiology to reduce the recurrence rate. Conclusion: Brain abscess associated with uncontrolled cyanotic congenital heart disease requires comprehensive treatment involving antibiotics and surgery. Addressing underlying causes and cost-effective follow-ups with clinical and monthly imaging assessments are essential.
Comparison of Therapy Effects Between A Single Non-Steroidal Anti-Inflammatory Drug and The Combination with Muscle Relaxant on The Degree of Lower Back Pain Santo Fitriantoro; Soedaly, Betty
Magna Neurologica Vol. 3 No. 1 (2025): 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.v3i1.1145

Abstract

Background: Lower back pain often results from poor ergonomic practice, characterized by localized discomfort between the costal border and lower gluteus folds, lasting more than one day. Possible factors contributing to this condition include age, gender, body mass index, ergonomics, load, work life, smoking habits, physical activity, or sports habits. Objective: This study aimed to examine the difference in therapy effects between a single non-steroidal anti-inflammatory drug (NSAID) (sodium diclofenac) and the combination of muscle relaxants (diazepam) against the severity of lower back pain. The degree of pain was assessed using the Alternative Method of Quantitative Pain Assessment (MAPKN) at HM Ryacudu Hospital, North Lampung. The sample consisted of 40 patients receiving medications at the Neurology Polyclinic. Methods: A quantitative method was used with a descriptive comparative approach. Results: The results showed that statistical analysis obtained a significance level of 0.737, indicating a normal data distribution. A paired sample t-test had a significance level of 0.000, which suggested a rejection of Ho and an acceptance of Ha. Conclusion: Based on the results, the combination therapy of NSAID (sodium diclofenac) and muscle relaxant (diazepam) was more effective in reducing lower back pain than using only an anti-inflammatory drug.
Virtual Reality-Based Rehabilitation’s Impact on Movement and Quality of Life in Parkinson’s: An Updated Systematic Review of Randomized Controlled Trials Muvida; Mustikasari, Hanif; Belawati, Yeny Ristaning; Amatillah, Hana
Magna Neurologica Vol. 3 No. 1 (2025): 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.v3i1.1720

Abstract

Background: Parkinson’s disease is a neurodegenerative disorder that can significantly impact an individual’s mobility, balance, and overall quality of life. It is characterized by movement disorders, including tremors, rigidity, bradykinesia, and gait disorder. In addition to pharmacological therapy, rehabilitation approaches play an important role in the management of occurring movement disorders. One of the potential rehabilitation methods is virtual reality (VR). Objective: This systematic review aims to determine the impact of VR-based rehabilitation on balance, mobility, motor function, and the quality of life of Parkinson's patients. Methods: Systematic research was conducted in February 2024 using PubMed, Scopus, and ScienceDirect. A combination of MeSH terms “virtual reality,” “Parkinson,” “exergame,” “effectivity,” and “rehabilitation” was used. The articles selected were randomized controlled trials published in the last ten years in English. The quality of articles was assessed using the Cochrane risk-of-bias tool. Analyses were stratified by outcomes: balance, mobility, motor function, and quality of life. Results: Fourteen randomized controlled trials with 637 patients were included. Most trials show that VR-based rehabilitation significantly improves balance compared to conventional rehabilitation. Mobility and motor function improve in the VR group, but its superiority remains controversial. Improved quality of life is observed, but no trials show statistical significance compared to conventional rehabilitation. Conclusion: This systematic review shows that VR-based rehabilitation has the potential to improve balance, mobility, motor function, and quality of life in Parkinson's patients.
Comparison of Seizure-Free Rates Between Levetiracetam and Phenytoin Administration in Seizure Patients with Brain Metastases Tumor (BM) During Period January 2023-December 2024 Hapsari, Dhiandra Dwi; Tejomukti, Teddy; Nastiti, Ranum Anggun
Magna Neurologica Vol. 3 No. 1 (2025): 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.v3i1.1726

Abstract

Background: Brain metastase tumor (BM) is the most frequently found intracranial tumor. The prevalence of seizures in BM ranges from 30%-50%. One of the treatments for seizure patients with BM is the administration of Anti-Epileptic Drugs (AED). The latest neuropharmacology now makes Levetiracetam (LEV) the first-line choice in BM cases compared to phenytoin (PHT), which was previously often used in BM cases. Objective: This study aims to compare seizure-free rates in patients with seizures on BM who received PHT or LEV treatment at Regional General Hospital Dr. Moewardi Surakarta from January 2023 – December 2024. Methods: An observational study using a cross-sectional method with a retrospective approach. Patients included were patients with BM who experienced seizures and received AEDs, either PHT 2x100 mg or LEV 2x500 mg, for a minimum duration of 6 months during the period January 2023–December 2024. Results: There were 50 research subjects with an age range of 38-67 years. The independent T-Test showed a significance value of 0.007 < value (0.05). In the group of patients given PHT, the seizure-free rate was 6.83±1.26 a (7 months), while in the LEV group, it was 9.02±0.85 b (9 months). Conclusion: A longer seizure-free rate in research subjects with LEV than PHT was found. This result is to previous research regarding the effectiveness of LEV as the leading choice in seizure patients with BM.
Vitamin D Deficiency in Relapsing Anti-NMDAR Encephalitis Presenting with Acute Cognitive Impairment: A Case Report Luthffia, Audiza; Cempaka Thursina Srie Setyaningrum; Amelia Nur Vidyanti; Desin Pambudi Sejahtera; Satiti, Sekar
Magna Neurologica Vol. 3 No. 1 (2025): 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.v3i1.1740

Abstract

Background: Anti N-methyl-D-aspartate Receptor (NMDAR) encephalitis is an autoimmune disease characterized by neuropsychiatric symptoms caused by autoantibodies against NMDAR. It is a treatable disease, but approximately 12-25% of  patients experience relapse. Vitamin D has several immunomodulatory effects and its deficiency is associated with systemic and neurologic autoimmune disease. Case:A 21-year-old woman presented with acute cognitive impairment, followed by status epilepticus during hospitalization. Two years ago, she was diagnosed with anti-NMDAR encephalitis and completely recovered after immunotherapy. During relapse, magnetic resonance imaging (MRI) showed chronic lacunar infarct on the right basal ganglia, and electroencephalography (EEG) showed diffuse slowing, identical to findings from the first event. Laboratory testing during relapse indicated vitamin D deficiency, which was normal before relapse onset. Symptoms improved following intravenous methylprednisolone, plasma exchange, vitamin D supplementation, and symptomatic treatment. Discussion: Inadequate immunotherapy has been suggested as a major risk factor for relapse, while other determinants have not been well recognized. Vitamin D inhibits proliferation of B cells, an important immunomodulator in anti-NMDAR encephalitis. Previous study revealed vitamin D levels were reduced in anti-NMDAR encephalitis patients and it is also thought to influence response to therapy. On the other hand, vitamin D also influence neurotransmitter activities and synaptic formation involved in cognitive and memory functioning. Conclusion: Anti-NMDAR encephalitis is a treatable autoimmune disease but still has the possibility of relapse. Vitamin D deficiency may be related with relapse of anti-NMDAR encephalitis. Routine screening for vitamin D deficiency can be considered in relapsed patients or during maintenance therapy.
A 22-Years-Old Male with Tuberculoma of the Brain and Spinal Cord with Miliary Tuberculosis Simamora, Rosinondang Deolita; Retnaningsih; Pasmanasari, Elta Diah; Muhartomo, Hexanto
Magna Neurologica Vol. 3 No. 1 (2025): 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.v3i1.1782

Abstract

Background: Tuberculosis (TB) remains a significant health issue in Indonesia. Central nervous system (CNS) tuberculoma is one of the extrapulmonary TB diseases and accounts for approximately 1% of all cases. The emergence of this disease is primarily associated with a weakened immune system. However, several other factors, such as comorbidities, a history of inadequate TB treatment, and poor nutrition, also play a role in the development of tuberculoma. Case: A 22-year-old male complained of weakness in all four limbs for the past month, accompanied by tingling and numbness from both feet up to the T10-11 dermatome level. The patient has a history of seizures from one year ago, interrupted treatment for military tuberculosis, and malnutrition. An MRI of the head and whole spine with contrast revealed tuberculomas. The patient was treated with medication, including intravenous dexamethasone 5 mg every 8 hours, oral phenytoin 200 mg every 24 hours, and anti-tuberculosis therapy. Discussion: Tuberculoma in the central nervous system is rare, especially multiple tuberculomas co-occurring in the brain and spinal cord. MRI is a sensitive tool for diagnosing tuberculomas, characterized by the presence of a target sign. The combination of corticosteroids, antiepileptic drugs, and an entire course of anti-tuberculosis medications aims to address both the immediate neurological symptoms and the underlying infection. Conclusion: TB can present as lesions in the brain and spinal cord, requiring the ability to correlate clinical manifestations and radiological features to establish a diagnosis and necessitating adequate therapy.

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