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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 52 Documents
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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.
Traumatic Spinal Cord  Injury Due to Horse Riding Accident in A Patient with Klippel-Feil Syndrome: A Case Report Christy Angeline; Hendra, Debora; Maria, Rani; Maulana Siahaan, Denny
Magna Neurologica Vol. 3 No. 2 (2025): July
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v3i2.1678

Abstract

Background: Spinal cord injury is a severe medical illness that frequently leaves patients permanently disabled and with severe morbidity. In some cases, sports may be one of the factors causing spinal cord injuries, like horse riding. Anatomical variation in the vertebra may become a potential risk factor for an injury such as Klippel-Feil syndrome. Case: A 30-year-old female came to the emergency room after falling while riding a horse. The patient complained of not being able to move her hands and feet and feeling numb from the neck area to the feet. X-rays of the cervical spine showed an anatomical variation in fusion at the C4 and C5 vertebrae, known as Klippel-Feil syndrome. No visible fracture or dislocation was found. The MRI results showed intramedullary lesions at the C3 to C5 vertebral bodies level and compression fracture of the C4-C5 vertebral body accompanied by narrowing of the C4-C5 intervertebral disc. Discussion: Patients with Klippel-Feil syndrome may be more vulnerable to transient neurologic deficits after minor trauma. The fused segments' altered mechanical force transfer, which results in the adjacent non-fused segments moving excessively, is most likely related to this. Conclusion: Serious medical conditions like spinal cord injuries often leave victims severely sick and permanently incapacitated. Sports such as horse riding are associated with traumatic spinal cord injuries. Patients with Klippel-Feil syndrome may be more susceptible to this trauma.
Virtual Conventional Therapy for Motor Rehabilitation in Stroke Patients: A Systematic Review Ilhamsyah, Rudi; Hambarsari, Yetty; Santoso, Markus; Gunawan, Hendry; Nur Ekasari, Esti; Hartanto, Krisandi; Yang, Han
Magna Neurologica Vol. 3 No. 2 (2025): July
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v3i2.1680

Abstract

Background: Stroke is a leading cause of disability worldwide, significantly impacting motor function, sensory, visual, and cognitive abilities. Conventional physical therapy has traditionally been used for stroke rehabilitation. However, technological advances have introduced virtual reality (VR) as a rehabilitation tool. Research has highlighted the therapeutic value of VR in improving motor functions, with some studies suggesting superior outcomes compared to traditional therapy. Despite this, the literature presents varied results, necessitating a systematic review to evaluate the breadth of evidence. Objective: This study aims to compare the effectiveness of VR therapy with conventional physical therapy in extremity function among stroke patients. Methods: A primary search was conducted across PubMed, Scopus, and ProQuest databases using keywords related to stroke, VR, and conventional therapy. Studies will be included if they compare the efficacy of VR with conventional therapy in stroke rehabilitation. Non-comparative studies, non-English publications, and irrelevant topics will be excluded. Results: A literature search yielded 15 eligible journals using a randomized clinical trial. Analysis showed that 4 out of 15 articles found VR therapy not superior to conventional therapy, while the other 11 articles demonstrated that VR therapy statistically improved patient conditions compared to conventional therapy. Conclusion: VR-based exercises stimulate cortical reorganization and strengthen neural systems involved in motor planning, learning, and execution. Most studies indicate that VR therapy is more effective in enhancing motor recovery, balance, and limb function in stroke patients and increasing patient motivation and engagement than conventional training.
A Case Report of 29-Years-Old Man with Hypokalemic Periodic Paralysis Mulyono, Rosi Dwi; Hasyim
Magna Neurologica Vol. 3 No. 2 (2025): July
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v3i2.1683

Abstract

Background: Primary hypokalemic periodic paralysis is a rare neuromuscular disorder of episodic muscle weakness. The estimated prevalence is 1:100.000. Hypokalemia is a decrease in serum potassium level <3.5 mmol/L. Hypokalemia can cause periodic paralysis. Case: A 29-year-old man complained of sudden weakness in four limbs, flaccid, proximal-dominant. Weakness in both legs on the first day, followed by weakness in both hands the next day. The patient ate a lot of rice 3 days before the attack. History of four limbs weakness 5 years ago. Upper limb motor strength was 4/3/3 | 3/3/4, and lower limb was 4/3/2 | 2/3/4. Potassium level was 2.59 mmol/L. Potassium correction therapy was performed with KCl 25 mEq in NaCl 0.9% 500cc at a rate of 20 TPM and KCl tablets 600mg/8 hours. The potassium level after the correction was 4.91 mmol/L. Motor strength returned to normal on the third day. Discussion: Our patient was diagnosed with hypokalemic periodic paralysis (HypoPP). The patient had moderate hypokalemia and returned to normal with a single correction. The leading cause of hypokalemia was suspected to be the underconsumption of potassium and overconsumption of carbohydrates. The patient's condition improved as potassium levels normalized. Conclusion: HypoPP is a rare neuromuscular disorder associated with hypokalemia, and the primary therapy is potassium correction. The cause of hypokalemia in this case is due to underconsumption of potassium and overconsumption of carbohydrates, but other causes of hypokalemia still need to be considered.

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