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Neurona
Published by Perhimpunan Dokter Spesialis Neurologi Indonesia
ISSN : 02166402     EISSN : 25023748     DOI : https://doi.org/10.52386/neurona
Core Subject : Health, Science,
Health Professions Medicine & Pharmacology Neuroscience
Neurona merupakan satu-satunya jurnal yang memuat perkembangan penelitian dan kasus terbaru bidang neurosains oleh Perhimpunan Dokter Spesialis Saraf (PERDOSSI) Pusat di Indonesia. Jurnal ini diterbitkan bulan Maret, Juni, September dan Desember. Bidang studi cakupan NEURONA meliputi: Stroke dan Pembuluh darah Neurotrauma Neuroonkologi Neuro Infeksi Neuro Behavior Neurorestorasi Neuropediatri Gangguan Tidur Nyeri Kepala Neurootologi Neuro Intervensi Neuro Intensif Neurogeriatri Gangguan Gerak Epilepsi Neuro Epidemiologi
Arjuna Subject : Kedokteran - Neurologi Klinis
Articles 299 Documents
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HUBUNGAN KOLESTEROL NON-HDL TERHADAP FUNGSI KOGNITIF PADA PASIEN STROKE ISKEMIK DENGAN DEFISIT NEUROLOGIS RINGAN Aylenia Lysandra; Budi Riyanto Wreksoatmodjo; Josephine Retno Widayanti
NEURONA Vol 37 No 3 (2020)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i3.163

Abstract

Introduction: Ischemic stroke patients have higher risk of cognitive decline. Severity of cognitive impairment depends on the severity of neurological deficit. The severity of cognitive impairment is also affected by abnormal non-HDL cholesterol level which includes atherogenic lipid that causes atherosclerosis. Aim: Understanding the association of non-HDL cholesterol and cognitive function in mild stroke patients at Atma Jaya Hospital in 2014-2018. Methods: A cross-sectional study by analyzing stroke registry patients (115 subjects). Data is analyzed by using Chi-square test and Fisher exact test. Results: Total sample of this research is 115 respondents. Mean age was 58±11,286 years old and 30,4% graduated from senior high school. 38,3% have cognitive impairment measured by Mini Mental State Examination (MMSE), of which 79.5% have abnormal non-HDL cholesterol. Meanwhile, 70,4% have cognitive impairment measured by Montreal Cognitive Assessment Indonesian Version (MoCA-Ina), of which 76.5% have abnormal non-HDL cholesterol. Cognitive function measured by MMSE and MoCA-Ina has no significant association with non-HDL cholesterol (respectively). Discussion: This research contradicted the previous research. It is suspected that there is no direct relationship between non-HDL cholesterol and cognitive function. Besides, cholesterol acts as antioxidant, has a role in neurotransmission and has a protective effect. Discussion: Cognitive function in patients with mild stroke, measured by MMSE and MoCA-Ina, is not associated with non-HDL Cholesterol. Keywords: Cognitive function, ischemic stroke, mild stroke, non-HDL cholesterol
HUBUNGAN KADAR ANTIBODI RESEPTOR ASETILKOLIN DENGAN DERAJAT KEPARAHAN PENYAKIT MIASTENIA GRAVIS DI RS CIPTO MANGUNKUSUMO Manfaluthy Hakim; Fika Tiara; Ahmad Yanuar; Winnugroho Wiratman; Luh Ari Indriawati; Astri Budikayanti; Fitri Octaviana
NEURONA Vol 37 No 3 (2020)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i3.164

Abstract

Introduction: Acetylcholine receptor (AChR) antibody is main antibody in pathogenesis of myasthenia gravis (MG). AChR antibody is an important diagnostic tests. Myasthenia gravis clinical features can be divided into ocular, generalized and bulbar MG. Severity of MG can be assessed based on MG composite score (MG-cs). Aim: To evaluate association between level of AChR antibody and MG severity based on MG severity in Cipto Mangunkusumo Hospital. Methods: This was a descriptive-analytic cross-sectional study which were done at Cipto Mangunkusumo Hospital during January to November 2017. Inclusion criteria were MG patients aged 18-75 years old. Assessment of MG composite score and blood withdrawal were performed at the same time. The level of AChR antibody was measured by ELISA method. Results: There were 72 subjects met inclusion criteria. Mean age was 43 years old (SD 12.56) with proportion higher in women (2.5:1). Ocular MG was the most initial symptom (79.2%) and early onset was the most common(77.8%). There were 59.7% subject who had seropositive AChR antibody. There was no significant association between seropositive AChR antibody and gender, age of onset, MG type, MGFa classification, immunotherapy. There was no association between level of AChR antibody and MG-cs(p=0.727). Discussion: There wasn’t any association between level of AChR antibody and MG severity based on MG-cs. Keywords: AChR antibody, MG composite score, MG severity
MEMBANGUN SISTEM CODE STROKE PADA DUA RUMAH SAKIT PENDIDIKAN DI INDONESIA Rakhmad Hidayat; Hirari Fattah Yasfi; Dinda Diafiri; Reyhan Eddy Yunus; Andi Ade Wijaya Ramlan; Taufik Mesiano; Mohammad Kurniawan; Al Rasyid; Salim Harris
NEURONA Vol 37 No 3 (2020)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i3.165

Abstract

Code stroke system is rapid respond system for ischemic stroke patient’s care to have immediate therapy in order to increase effectiveness and achieve maximum outcome. Cipto Mangunkusumo Hospital and Universitas Indonesia Hospital are educational hospitals with different background, resources, facilities, and conditions in code stroke system implementation. This paper compares the code stroke system between both hospitals from some aspects, such as emergency unit health care providers, cost and facility, diagnostic imaging, initiator of code stroke system, observation room, availability of catherization lab, and communication within code stroke team. Code stroke system can be implemented in many hospitals correspondingly adjusting each of hospital conditions by maximizing advantages to cover the hospital’s shortcomings. Keywords: Code stroke, hospital, ischemic stroke, thrombectomy, thrombolysis
MULTIPEL SKLEROSIS PROGRESIF SEKUNDER, GEJALA KLINIS, DIAGNOSIS, DAN TATA LAKSANA Riwanti Estiasari; Nadia Devianca; Kartika Maharani; Darma Imran
NEURONA Vol 37 No 3 (2020)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i3.166

Abstract

Multiple sclerosis (MS) is a chronic inflammatory autoimmune disorder of the central nervous system (CNS) affecting the myelin. MS is very detrimental which causes disability and will reduce the productivity and quality of life of the patients, especially if it progressed to secondary progressive multiple sclerosis (SPMS) which there will be a continuous worsening of neurological deficits. Early detection of symptom progression can be done to overcome the problems that may occur in SPMS. By early detection, immediate therapy of SPMS can be given thus preventing the progression. It is therefore important for us to know the definition of SPMS, how to detect progression, and the treatment options for SPMS that will be explained in this literature review. Keywords: Progression, therapy, SPMS
TUBERKULOMA SEREBRAL PADA PENDERITA ACQUIRED IMMUNE DEFICIENCY SYNDROME Vincent Ongko Wijaya; Dony Ardianto; Gama Sita Setya Pratiwi; Anton Mahendra; Glennis Widra Shintyalola; Rasi Irfan Asany
NEURONA Vol 37 No 3 (2020)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i3.167

Abstract

Cerebral tuberculoma is a central nervous system complication which rare and jeopardize due to tuberculosis (TB) infection. The authors reports a case of a 23 years old female with history of human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) and under treatment for active TB, presented with headache and dizziness since 1 week before admission. Neurological examination in normal range. Lab value showed decrease level in CD4 absolute and continue with contrast head CT scan. The patient has been given main therapy with dexamethasone, cotrimoxazole, and anti-tuberculosis drugs Keywords: HIV/AIDS, tuberculoma, tuberculosis
METASTASIS OTAK TIPE MILIER PADA KASUS ADENOKARSINOMA PARU DENGAN MUTASI EGFR T790M I Made Oka Adnyana; Ni Luh Putu Eka Arisanti
NEURONA Vol 37 No 3 (2020)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i3.168

Abstract

Brain metastasis is the most common intracranial tumor with the number of events exceeding primary brain tumors. It still holds high mortality and morbidity rate to date. Most of the metastases are macroscopic parenchymal mass lesions with surrounding edema and occurred in the gray-white matter junction. Miliary brain metastasis is a rare condition with generally poor prognosis. A male patient, 51 years old, Balinese, was admitted with decreasing consciousness since 1 week ago. The patient was diagnosed with lung adenocarcinoma with positive EGFR mutation in March 2019 and since April 2019 was started taking gefitinib 200mg every 24 hours. The patient also had intermittent headaches accompanied by vomiting, the head MRI with contrast showed multiple-miliary punctate lesions on almost every brain tissue, suggesting miliary type metastases. Further investigation revealed a positive EGFR T790M mutation. Miliary type brain metastases is a rare condition with poor prognosis. Chemotherapy and radiotherapy do not provide a satisfactory result. Miliary metastases pattern should be considered in differential diagnoses of patients with progressive dementia and multiple lesions as numerous diseases have similar head CT scan appearances. To this date, there is no standard therapy regimen for miliary brain metastases but some studies showed that the combination of whole-brain radiotherapy and EGFR tyrosine kinase inhibitor was deemed as having beneficial effects. The survival rate on these cases range from 14 days to 24 months. Keywords: Adenocarcinoma, brain, lung, metastases, miliary type
GAMBARAN ELEKTROENSEFALOGRAFI PADA MENINGITIS TUBERKULOSIS YANG MENGALAMI BANGKITAN SIMTOMATIK AKUT Hendra Irawan; Suryani Gunadharma; Sobaryati Sobaryati
NEURONA Vol 37 No 4 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.169

Abstract

Introductions: Electroencephalography (EEG) can detect abnormal cortical excitability, causing epileptic seizure. Acute symptomatic seizure can caused by tuberculous meningitis (TBM) which can further develope to symptomatic epilepsy. We are interested to study the characteristic of EEG pattern in TBM patients with acute symptomatic seizure. Aims: To investigate characteristic of EEG pattern in TBM with acute symptomatic seizure. Methods: This was an descriptive observational study, from secondary medical record datas and EEG reports from acute symptomatic seizure patients caused by TBM during admited in Hasan Sadikin General Hospital, in 11 years periode from January 2006 to December 2016. Results: Fourty four subjects were enrolled in this study. The EEG pattern showed focal slowing 70.5%, 61.4% had unilateral focal slowing, and 9.1% had bilateral focal slowing. Focal epileptogenic waves were only found in 25.0% and 4.5% showed triphasic waves. Discussion: Electroencephalogram in acute symptomatic seizure due to TBM showed abnormality in 100% subjects. Almost all EEG abnormality concordances with neuro imaging findings. Keyword: Acute symptomatic seizure, EEG, tuberculous meningitis
KADAR GLIAL FIBRILLARY ACIDIC PROTEIN SERUM TINGGI SEBAGAI FAKTOR RISIKO NYERI NEUROPATIK PADA KUSTA TIPE MULTIBASILER Sofyan Faridi; I Made Oka Adnyana; I Putu Eka Widyadharma; Luh Made Mas Rusyati
NEURONA Vol 37 No 4 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.170

Abstract

Introduction : Leprosy is one of the most common causes of non-traumatic peripheral neuropathy in the world. There are many factors causing neuropathic pain in multibacillary (MB) type leprosy, one of which is an increase in serum levels of glial fibrillary acidic protein (GFAP). Aim: To prove high serum GFAP levels is a risk factor for neuropathic pain in MB type leprosy in Sanglah General Hospital Denpasar. Methods: This study was an observational analytic study with a case control design conducted at the Dermato-Venerology Department outpatient and in Pathological Clinic Laboratory in Sanglah General Hospital from November 2019 to January 2020. The sample of this study is all multibacillary leprosy patients with neuropathic pain who met inclusion criteria. A total of 60 patient were willing to participate in this study, the pain scales were measured using DN4 questionnaire and GFAP serum levels were examined. Chi-square test was performed to prove high serum GFAP levels is a risk factor of neuropathic pain in multibacillary leprosy. Results: High serum GFAP levels increase the incidence of neuropathic pain of MB type leprosy 5 times higher than controls (OR 5.72; p = 0.003), anxiety (OR 2.1; p = 0.24), and leprosy reaction (OR 2.2; p = 0.052). Discussion: High serum levels of GFAP is a risk factor of neuropathic pain in MB type leprosy in Sanglah General Hospital Denpasar. Keywords: GFAP, MB type leprosy, neuropathic pain
EVALUASI TAJAM PENGLIHATAN DAN INDEKS PROPTOSIS PASIEN MENINGIOMA SPHENOORBITA PASCAOPERASI KRANIEKTOMI Renindra Ananda Aman; Ryan Rhiveldi Keswani; Syaiful Ichwan; Samsul Ashari; Setyo Widi Nugroho
NEURONA Vol 37 No 4 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.171

Abstract

Introduction: Sphenoorbital meningioma (SOM) is an exophytic tumor mass that infiltrates the bone at the sphenoid wing, lateral orbital walls, orbital roofs, and extends to superior orbital fissures. The classic triad of clinical features are proptosis, decreased visual acuity, and ophthalmoplegia. The outcomes of our postoperative patients have not been evaluated before. Aim: We would like to evaluate the clinical characteristics of the sphenoorbital menigioma patients before and after surgery. Methods: A cross sectional study was performed. Subjects were patients with sphenoorbital meningiomas who came to Cipto Mangunkusumo General Hospital from January 2014 through December 2015. All patients underwent craniectomy and lateral orbitotomy. We evaluated the visual acuity using the Snellen chart and proptosis index before and after surgery by measuring the protuded eye in an axial CT scan. Results: There were 66 samples in this study, and 65 of the samples were females. The age range is from 31 to 64 years. The mean proptosis index of preoperative is 18.27 and the post operative is 16.43. The mean proptosis index reduction is 1.84. Post operative visual acuity was improved only in 3 (9.7%) samples. Discussion: Sphenoorbital meningioma patients after surgery were shown markedly improvement in the proptosis index. However, the visual acuity was not markedly improved after surgery. Keywords: Proptosis index, sphenoorbital meningioma, visual acuity
KESINTASAN PASIEN DENGAN METASTASIS LEPTOMENINGEAL YANG DIRAWAT DI BAGIAN NEUROLOGI RUMAH SAKIT KANKER DHARMAIS DAN RSUPN DR CIPTO MANGUNKUSUMO Elsa Susanti; Rini Andriani; Tiara Aninditha; Henry Riyanto Sofyan
NEURONA Vol 37 No 4 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.172

Abstract

Introduction: Leptomeningeal metastasis is a condition where malignant cells spread to the leptomening and subarachnoid space. This is an emergency state with incident tends to increase each year. Prognosis is very poor and survival rate is only 10-15 weeks. Aim: To determine survival of leptomeningeal metastasis patients in Cancer Dharmais Hospital and Cipto Mangunkusumo Hospital. Methods: This is a retrospective cohort research based on medical records of leptomeningeal metastasis patients in Cancer Dharmais Hospital and Cipto Mangunkusumo Hospital from January 2018 to June 2019. Clinical examination, liquor cerebral examination, MRI, and histopathological of primary tumours were written. Subjects or family of the subjects were contacted to obtain information about subject’s wellbeing whether they’re still alive or dead. If they’re unreachable they will be excluded. Survival of each subject was determined based on how long the subject remain alive since being diagnosed with leptomeningeal metastasis until the end of observation, which is the end of the research. Results: Sixty two patients were included in the research, 21 were males and 41 were females. Headache was the most frequent symptoms found in the patients (46.8%) followed by cranial nerves deficits (45.2%). Median survival in this research was 13 weeks, no significant differences in survival from haematologic malignancy and solid tumor. Discussion: Median survival of leptomeningeal metastasis patients was 13 weeks, there was no statistically significant difference between survival of heamotologic malignancy and solid tumor. Median survival in leptomeningeal metastasis in this research remain poor regardless the origin of the metastasis. Keywords: Haematologic malignancy, leptomeningeal metastasis, solid tumor, survival

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