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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 82 Documents
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Successful Pudendal Nerve Block and Radiofrequency in 4 Years Scrotal Pain Resistant to Treatment and Three Varicocelectomies: A Case Report Yang Yang Endro Arjuna; Tasya Meidy Pradhana; Yusak Mangara Tua Siahaan
Magna Neurologica Vol. 4 No. 1 (2026): 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.v4i1.2259

Abstract

Background: Only a small percentage of patients (2-10%) report pain symptoms during varicocele or post-varicocelectomy. The cause of the pain remains unclear and is still a matter of debate. Neither conservative nor surgical treatments provide a conclusive solution for pain. Nerve blocks can serve as a diagnostic and therapeutic tool in cases where the origin of pain is unknown. Case: A 30-year-old male presented with 4 year history of chronic scrotal pain, worsening over the past three weeks. The pain, rated 6/10 on the Numeric Rating Scale (NRS), was unrelieved by rest or analgesics and worsened at night and with prolonged sitting (NRS 7/10), significantly impacting daily activities. He had bilateral recurrent varicocele and underwent three varicocelectomies and ureteroscopy. Oral analgesics and neuropathic pain medications provided only temporary relief. The neurological examination revealed hyperalgesia in the distribution of the pudendal nerve. The imaging results were expected. Discussion: A notable reduction in pain was observed following an ultrasound-guided diagnostic pudendal nerve block with 2 mL of 2% lidocaine, confirming pudendal neuralgia related to varicocele or post-varicocelectomy. The pain is likely due to compression of the pudendal nerve branch by an enlarged pampiniform plexus.  Pulsed radiofrequency is utilized to provide longer-lasting pain relief. No complications were reported after the treatment.      Conclusion: Pudendal nerve blocks can alleviate scrotal pain and may be an alternative to genitofemoral and ilioinguinal nerve blocks. This is the first report of a successful pudendal nerve block for scrotal pain associated with varicocele or varicocelectomy.
Non-Traumatic Subarachnoid Hemorrhage with Brain Abscess due to Eisenmenger Syndrome: A Rare Case Report Muhammad Ikhlas Muttaqin Aditiarman; Dhesty Fadhilah Faatin; Ni Nyoman Ayu Susilawati
Magna Neurologica Vol. 4 No. 1 (2026): 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.v4i1.2274

Abstract

Background: Non-traumatic subarachnoid hemorrhage in patients with congenital heart disease, such as Eisenmenger syndrome, may involve multiple organs and carries a risk of cerebral abscess due to multiorgan mechanisms. Case: A 20-year-old male with untreated congenital heart disease since childhood was admitted with severe headache, neck stiffness, projectile vomiting, fatigue, lip curling, slurred speech, and stroke-like symptoms. Neurological deficits included right-dominant tetraparesis, accompanied by cyanosis and clubbing of fingers. CT scan revealed a subarachnoid hemorrhage extending into the perimesencephalic cistern with a thick-walled hypodense lesion, suspected to be a brain abscess. Laboratory findings revealed secondary erythrocytosis, characterized by elevated hematocrit and erythrocyte levels. Discussion: In this case, the subarachnoid hemorrhage was non-traumatic and perimesencephalic, likely caused by a mycotic aneurysm associated with Eisenmenger syndrome. The brain is a frequent target of septic emboli linked to mycotic aneurysms that trigger hemorrhage. Hemodynamic instability contributes to arterial endothelial degeneration, while hyperviscosity from congenital heart disease and septic embolism facilitates aneurysm formation. Rupture of such aneurysms leads to a sudden rise in intracranial pressure, worsening neurological outcomes. Conclusion: Subarachnoid hemorrhage in Eisenmenger syndrome is strongly associated with mycotic aneurysms from septic emboli, which may progress to cerebral abscess due to diffuse hypoxia from impaired cardiac output. Early diagnostic evaluation is crucial to establish the etiology, and heightened vigilance is needed in Eisenmenger cases, given the elevated risk of subarachnoid hemorrhage through septic emboli and aneurysm rupture.
Fahr Disease in Elderly Patients with Bronchopneumonia and History of Ischemic Stroke: A Case Report and Literature Review Miftahul Hasanah; Aditya Putra Priyahita
Magna Neurologica Vol. 4 No. 1 (2026): 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.v4i1.2392

Abstract

Background: Fahr's Disease (Fahr's Syndrome) is a rare condition characterized by idiopathic bilateral basal ganglia calcifications, typically occurring in the lateral parts of the globus pallidus, dentate nuclei, and caudate nuclei. Diagnosis is based on clinical features of neuropsychiatric and somatic symptoms in conjunction with radiological findings. We report an unusual case of Fahr's disease in a 70-year-old woman with bronchopneumonia and a history of chronic ischemic stroke identified through a CT-SCAN. Case: The patient was a 70-year-old female, admitted to our emergency department with bronchopneumonia, who presented with declining consciousness and focal seizures for 3 hours before entering the hospital. Her brain’s CT scan revealed calcification in the bilateral lentiform nuclei, bilateral cerebellar dentate nuclei, and left corona radiata, consistent with Fahr's disease. The patient was also diagnosed with bronchopneumonia and chronic ischemic stroke. Discussion: Fahr's Disease is linked to abnormal calcium metabolism, leading to calcifications in the basal ganglia. While chronic ischemic stroke may not directly cause Fahr's Disease, it increases the risk of cerebrovascular events in affected individuals. The correlation between infection and Fahr's Disease is poorly understood, although it may exacerbate neurological symptoms. Conclusion: Basal ganglia calcification in Fahr's disease may be associated with an increased risk of stroke and bronchopneumonia, which can worsen the patient's condition. Further research is needed to understand the relationship between Fahr's disease, ischemic stroke, and infections.
Cell Based Treatment for Spinocerebellar Ataxia: A Clinical Case Report Damar Dyah Mentari; Rivan Danuaji
Magna Neurologica Vol. 4 No. 1 (2026): 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.v4i1.2412

Abstract

Background: Spinocerebellar ataxia (SCA) is a dominant and monogenic central nervous system disorder, characterized by progressive motor disorders affecting coordination, balance, speech, and ADL. The prevalence is 2.7 out of 100,000 people. Currently, cell-based therapy is being developed for clinical improvement in SCA. Case: A 48-year-old woman with weakness in both legs and arms, difficulty walking, dysmetria, and dysarthria since 2015. Examination of SARA scoring is severe ataxia, EMG showed polyradiculopathy, muscle denervation, and suspicion of posterior ramus lesions; complete blood laboratory and tumor markers were routine. MRI brain contrast and whole spine contrast radiology imaging were also performed. Clinical improvement was achieved in 2016 following stem cell injection in Thailand (dose and type of cells unknown). However, clinical worsening occurred from 2020 to 2024. The patient received Umbilical Cord Mesenchymal Stem Cells (MSC) in October 2024, administered intrathecally at a dose of 20 million cells. Discussion: The first injection showed significant clinical improvement. The second injection showed no clinical improvement, but no worsening of symptoms was found. The difference in results may be due to variations in the route of administration, cell type, cell quality, and the dose administered. Conclusion: The administration of umbilical cord mesenchymal stem cells (UC-MSCs) in SCA is considered safe, with minimal complications, and can suppress disease progression, although it does not produce clinical improvement.
Vitamin D Receptor Gene Polymorphisms in Multiple Sclerosis Susceptibility: Updated Systematic Review and Meta-Analysis Han Yang; Baarid Luqman Hamidi; Esti Nur Ekasari; Krisandi Hartanto; Rudi Ilhamsyah
Magna Neurologica Vol. 4 No. 1 (2026): 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.v4i1.2417

Abstract

Background: The relationship between Vitamin D Receptor (VDR) gene polymorphisms and the risk of developing Multiple Sclerosis (MS) has been explored in numerous studies. However, the results were inconclusive. Therefore, this study aimed to investigate the relationship between VDR gene polymorphisms and susceptibility to MS. Objective: This study aimed to systematically evaluate the association between Vitamin D Receptor (VDR) gene polymorphisms and susceptibility to Multiple Sclerosis (MS) through a meta-analysis of existing studies. Methods: This study is a meta-analysis conducted in accordance with the PRISMA guideline. The literature search was conducted using the PubMed and Google Scholar databases from January 2014 to December 2024. Studies included in this meta-analysis were assessed using the Newcastle-Ottawa Scale (NOS). The association between VDR polymorphisms and the risk of MS was evaluated using pooled odds ratios (ORs) and 95% confidence intervals (CIs). Results: Six studies (868 cases/982 controls) were included. The TaqI polymorphism showed that TT vs TC + CC was associated with reduced risk of MS (OR 95% CI = 0.43 [0.21 - 0.86], p = 0.02), while CC vs TT + TC was associated with an increased risk of MS (OR 95% CI = 1.89 [1.51 - 2.36], p < 0.00001). T vs C was associated with reduced risk of MS (OR 95% CI = 0.69 [0.49 - 0.98], p = 0.04) while C vs T was associated with an increased risk of MS (OR 95% CI = 1.45 [1.02 – 2.05], p < 0.04). Conclusion: In summary, our meta-analysis revealed a significant association between VDR gene polymorphism and MS susceptibility in certain genetic models of the VDR gene.
Oligodendrocyte Differentiation from Human iPSCs: Strategies Based on Signaling Pathways, Transcription Factors, and Novel Modulators for Research and Therapy Maria Maylyn Evangelina Wong; Michelle Angelica Subrata
Magna Neurologica Vol. 4 No. 1 (2026): 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.v4i1.2601

Abstract

Background: Oligodendrocytes (OLs) are vital for central nervous system (CNS) function, producing myelin sheaths and maintaining axonal integrity. However, their limited accessibility in human disease-relevant contexts has historically hindered progress in research. The advent of induced pluripotent stem cell (iPSC)-derived OLs has transformed the study of myelin-related diseases and regenerative therapies. Objective: This review aims to provide a comparative overview of strategies for generating OLs from human iPSCs, emphasizing their mechanisms, efficiency, scalability, and translational applications. Methods: We analyzed three major differentiation approaches described in recent literature. Signaling-based protocols replicate developmental processes by modulating TGF-β, SHH, and Wnt pathways. Transcription factor-driven methods accelerate lineage specification by directly inducing OL fate. Modulator-enhanced strategies incorporate epigenetic, metabolic, or environmental cues to improve efficiency and adaptability. Results: Each approach offers distinct strengths and limitations. Signaling-based methods closely mimic in vivo development but require long culture times. Transcription factor-driven strategies enable rapid OL generation, although sometimes at the expense of physiological relevance. Modulator-enhanced protocols represent an emerging avenue, offering flexibility and potential for higher efficiency. Collectively, these strategies expand opportunities for disease modeling, therapeutic screening, and cell replacement therapies. Conclusion: Advances across signaling, transcriptional, and modulatory domains have significantly advanced iPSC-based OL generation. Integration of these approaches may enable more efficient, scalable, and physiologically relevant OL production. Such progress holds significant potential to accelerate the development of myelin targeted therapeutics and enhance translational research in demyelinating diseases.
Acute Malignant Transformation as A Rare Complication of Middle Cerebral Artery Infarction Annisa Bunga Nafara; Ika Yulieta Margaretha Permatasari
Magna Neurologica Vol. 4 No. 1 (2026): 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.v4i1.2644

Abstract

Background: Malignant ischemic stroke is a stroke characterized by extensive acute edema resulting in a space-occupying lesion. This transformation occurs in 10% of ischemic strokes with a mortality rate up to 80%. Hence, it is crucial to early detection and timely treatment. Case: A 51-year-old male was diagnosed with ischemic stroke, presented with NIHSS 11 and ASPECTS 4. Within 26 hours, the patient's level of consciousness declined progressively from a GCS of 15 to a GCS of 10. Serial brain imaging using CT scan and MRI revealed infarct expansion, a space-occupying lesion, and further midline shift. During decompressive craniectomy, extensive edema was found without hemorrhage, suggesting malignant ischemic stroke. After 6 months, the patient had undergone cranioplasty, with no significant complaints, but left hemiparesis remained. Discussion: Malignant ischemic stroke occurs within 5 days after onset. Diagnosis of malignant complication should be considered in ischemic stroke patients with younger age, higher NIHSS, not receiving thrombolysis, neurological status decline in 4-6 hours after onset, wide hypoattenuation in MCA territory, and signs of progressive space-occupying lesion in brain imaging. Management of malignant ischemic stroke consists of managing intracranial pressure with pharmacology and decompressive craniectomy. Conclusion: Malignant transformation is a rare complication of ischemic stroke. Early and accurate diagnosis is crucial to determine the prognosis. Pharmacological therapy and decompressive craniectomy surgery are considered life-saving therapies, but are not able to reduce morbidity in the patient.
COMPARISON OF LIPID PROFILE LEVELS IN PATIENTS WITH ISCHEMIC STROKE AND HEMORRHAGIC STROKE AT RADEN MATTAHER HOSPITAL JAMBI Alfi Khaira; Mirna Marhami Iskandar; Nyimas Natasha Ayu Shafira
Magna Neurologica Vol. 4 No. 2 (2026): 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.v4i2.1983

Abstract

Background: Stroke attacks the brain, causing neurological disorders and even death. In 2023, there were 337 stroke cases at RSUD Raden Mattaher Jambi. Objective: This study aims to analyze differences in lipid profile levels between patients with ischemic and hemorrhagic strokes at Raden Mattaher Hospital in 2023. Methods: This study used a cross-sectional comparative analytical design with a quantitative approach, and the sample consisted of 101 ischemic and 101 hemorrhagic stroke patients, each selected through purposive sampling. Results: Findings showed that the majority of ischemic and hemorrhagic stroke patients were aged 56-65 years. Ischemic stroke patients were predominantly female, while men were predominantly affected by hemorrhagic stroke. Most stroke patients had normal pulse rate and body temperature, with blood pressure most frequently in stage 2 hypertension. Respiratory rates were normal in ischemic stroke patients but showed tachypnea in hemorrhagic stroke. Triglyceride and LDL levels were higher on average in ischemic stroke patients, while total cholesterol and HDL levels were higher in hemorrhagic stroke patients. Conclusion: Significant differences were observed in lipid profile components, specifically triglycerides, HDL, and LDL, between patients with ischemic and hemorrhagic strokes. However, there was no significant difference in total cholesterol levels.
FACTORS INFLUENCING THE INCIDENCE OF REFRACTORY EPILEPSY: A SCOPING REVIEW Naufal; Desin Pambudi Sejahtera; Ishana Nafeeza Mukhtar; Atitya Fithri Khairani; Nur Chayati
Magna Neurologica Vol. 4 No. 2 (2026): 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.v4i2.2572

Abstract

Background: Epilepsy affects around 50 million people worldwide, with an incidence of 100 cases per 100,000 people annually in developing countries where access to adequate treatment is limited. Refractory epilepsy occurs in 20-40% of cases of patients whose seizures remain uncontrolled despite 1-2 years of adequate anti-seizure medication (ASM) therapy with good adherence. This condition poses significant challenges for management. Objective: This scoping review aimed to systematically identify the factors associated with refractory epilepsy. Methods: A scoping review was conducted in accordance with the PRISMA-ScR guidelines and the PEO/PET framework. A systematic PubMed search identified studies published between 2020 and 2025 on factors influencing refractory epilepsy. Eligible studies underwent a three-phase screening process (title, abstract, and full-text review). Results: Twenty studies met the inclusion criteria, comprising seven review articles and thirteen clinical studies, most of which were observational. Recurrent associations between refractory epilepsy and several factors were identified, such as one large cohort of 5,794 patients reporting seizure onset within the first year of life to be the strongest predictor of refractory epilepsy, while another study showed that structural etiology increased the odds more than threefold (OR 3.47; 95% CI: 1.15-10.43). Psychiatric comorbidities, developmental delay, abnormal EEG or neuroimaging findings, and systemic contributors such as inflammation and metabolic disorders were also found to be commonly associated with refractory epilepsy. Conclusion: The most frequently reported factors for developing refractory epilepsy across studies were younger age at first seizure, structural etiology, and genetic factors.
ISCHEMIC STROKE PRESENTING AS ISOLATED DIZZINESS IN A PATIENT WITH TYPE 2 DIABETES MELLITUS AND CONGESTIVE HEART FAILURE: A CASE REPORT Elsa Lase; Rio Tasti Surpa Rahmat Bintan; Kamila Auliya
Magna Neurologica Vol. 4 No. 2 (2026): 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.v4i2.2586

Abstract

Background: Ischemic stroke may manifest with a wide range of clinical symptoms, including atypical presentations such as dizziness, especially in patients with complex cardiovascular and metabolic risk profiles. This case report describes the clinical course and management of ischemic stroke in a patient with pre-existing cardiovascular disease and type 2 diabetes mellitus. Case: A 61-year-old woman with a history of cardiovascular disease and type 2 diabetes mellitus presented with sudden disorientation and persistent dizziness. On the second day of hospitalization, she developed right-sided weakness, facial asymmetry, and slurred speech. A head CT scan revealed infarctions in the left occipital lobe and left corona radiata. Due to the unavailability of thrombolytic therapy at the local hospital, the patient was managed conservatively with 80 mg aspirin, 75 mg clopidogrel, citicoline, and insulin. Discussion: Dizziness/vertigo is recognized but is often an overlooked symptom of ischemic stroke, particularly in posterior circulation strokes. Approximately 20% of ischemic strokes involve the vertebrobasilar system, where vertigo is a predominant symptom. Type 2 diabetes mellitus and cardiovascular comorbidities significantly increase the risk of ischemic events. Patients presenting with dizziness or vertigo are at higher risk of subsequent stroke or cardiovascular events compared to those without these symptoms. Conclusion: This case underscores the importance of recognizing dizziness as a potentially subtle and early manifestation of ischemic stroke, especially in patients with complex cardiovascular and metabolic risk profiles, such as type 2 diabetes mellitus. Prompt evaluation and appropriate management are crucial for preventing progression and improving outcomes.

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