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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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MIKROALBUMINURIA SEBAGAI PREDIKTOR LUARAN BURUK STROKE ISKEMIK AKUT DI RUMAH SAKIT UMUM PUSAT SANGLAH DENPASAR Hesti Heptaningrum; I Made Oka Adnyana; Thomas Eko Purwata
NEURONA Vol 37 No 4 (2020)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.173

Abstract

Introduction: Microalbuminuria is one of indicators for systemic endovascular damage related to endothelial damage and dysfunction. Microalbuminuria has become an important risk factor for predicting the risk and prognosis of cerebrovascular disease. However, its association with acute ischemic stroke remains unclear, particularly those related with other comorbidities. Aim: To address the role of microalbuminuria as a predictor of poor neurological outcome among patients with acute ischemic stroke at Sanglah Hospital Denpasar. Methods: This was a prospective cohort study involving acute ischemic stroke patients admitted at Sanglah Hospital Denpasar during October to December 2018. All patients who fulfilled inclusion and exclusion criteria and provided consent to participate in the study were included. Microalbuminuria was measured with albumin to creatinine ratio with concentration of 30–300mcg/mg. Stroke outcome was classified into either good or poor according to early and late National Institutes Health Stroke Scale (NIHSS) score (during patient’s admission and 7th day, respectively). Bivariate and multivariate statistical analyses were conducted. Results: Sixty patients were recruited. Microalbuminuria increased poor neurological outcome among stroke patients significantly (RR 5.47; 95% CI 2.17–13.8; p<0.001). Multivariate analysis demonstrated that microalbuminuria (RR=21.99; 95% CI 2.01-240.41; p=0.011), DM (RR=11.66; 95% CI 2.00–67.65; p=0.006), and dyslipidemia (RR 11.45; 95% CI 1.10–119.23; p=0.041) as an independent predictor of poor neurological outcome among acute ischemic stroke patients. Discussion: Therefore, microalbuminuria is consistently independent predictors of poor outcome in admitted acute ischemic stroke patients. Keywords: acute ischemic stroke, microalbuminuria, poor neurological outcome
KARAKTERISTIK METASTASIS SISTEM SARAF PUSAT DARI KANKER PARU Tan Yosephine; Tiara Aninditha; Henry Riyanto Sofyan; Jonathan Odilo; Rini Andriani
NEURONA Vol 37 No 4 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.174

Abstract

Introduction: As much as 40% of lung cancer patients will experience central nervous system (CNS) metastasis in the course of the disease. From those 40%, as much as 3-9% will experience leptomeningeal metastasis, but the clinical profile of CNS involvement in lung cancer has never been studied before in Indonesia. Aim: To give a description of CNS metastasis from lung cancer inCipto Mangunkusumo General Hospital and National Cancer Referral Dharmais Hospital. Methods: This is a cross-sectional study done in patients consulted to Neurology Department inCipto Mangunkusumo General Hospital and National Cancer Referral Dharmais Hospital in 2018. Inclusion cirteria is adult patients diagnosed with lung cancer based on histopathology with complete medical record to the extent of CT scan or Head MRI with contrast. Results: There were 48 subjects with median age of 57 (36-76) years, men were more than women (56.2% vs 44.8%) and 31.3% had history of smoking. The most frequent lung cancer type is non-small cell lung cancer (NSCLC) (93,8%). Neurological symptoms found were motoric deficits (62.5%), headache (43.8%), cognitive dysfunction (20.8%), and seizure (18.8%). Majority of subjects suffered from brain metastasis (93.8%) and 8.3% were leptomeningeal metastasis. Discussion: The majority of CNS metastasis were brain metastasis from NSCLC (93.8%) with main neurological deficits were motoric deficits (62.5%) and headache (43.8%). Keywords: Brain metastasis, lung cancer, non-small cell lung carcinoma
HUBUNGAN WAKTU TUNGGU MENUJU OPERASI PENGANGKATAN TUMOR INTRAKRANIAL DENGAN SKALA PERFORMA KARNOFSKY PASCAOPERASI Setyo Widi Nugroho; Aryandhito Widhi Nugroho; Renindra Ananda Aman; Hanif Gordang Tobing
NEURONA Vol 37 No 4 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.175

Abstract

Introduction: The waiting time to elective intracranial tumor removal surgery in Indonesia is unknown, let alone its association with postoperative functional outcome. Aim: To identify the waiting time to elective intracranial tumor removal and to analyze its association with poor functional outcome, defined by 3-months postoperative Karnofsky Performance Scale (KPS score) of <70. Methods: This medical record-based retrospective study was performed on intracranial tumor patients underwent elective tumor removal surgery in 2016. Multivariable logistic regression analyses were utilized to determine any significant association between waiting time to elective intracranial tumor removal surgery and poor functional outcome, adjusting for age, sex, preoperative KPS score, pre- and postoperative tumor volume, percentage of tumor removal, tumor histopathology, and grading. Results: Data were obtained from 191 patients, with histopathology distributions as follows: 49% meningiomas, 22% pituitary adenomas, 9% astrocytomas, 3% metastatic tumors, 3% primary central nervous system lymphomas, 2% oligodendrogliomas, 2% craniopharyngiomas, and 10% others. Overall median (min-max) of waiting time to elective intracranial tumor removal surgery was 35 (0-529) days. Significant association between waiting time to elective intracranial tumor removal surgery and poor functional outcome was evident in univariable analysis (OR 1.004), but not in multivariable analysis. The collinearity value of pre- and postoperative tumor volume, percentage of tumor removal with waiting time were, respectively, 5.92; 5.69; and 3.2. Discussion: There was no significant association between waiting time to elective intracranial tumor removal surgery and poor functional outcome. Strong collinearities were identified between pre- and post-operative tumor volume, percentage of tumor removal and waiting time to elective intracranial tumor removal surgery. Keywords: functional outcome, intracranial tumor, removal surgery, waiting time
UJI VALIDITAS DAN RELIABILITAS KUESIONER THE 15-ITEM MYASTHENIA GRAVIS QUALITY OF LIFE SCALE VERSI BAHASA INDONESIA (MG-QOL15 INA) Fitri Octaviana; Ahmad Yanuar Safri; Fikry Syahrial; Luh Ari Indrawati; Winnugroho Wiratman; Manfaluthy Hakim
NEURONA Vol 37 No 4 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.176

Abstract

Introduction: Myasthenia gravis (MG) is a chronic autoimmune disease in the neuromuscular junction characterized with fluctuating weakness symptoms. Advance in the diagnosis and management of MG cases increases the patient’s life expectancy therefore the evaluation of therapeutic success is no longer based solely on coping with the symptoms, but also in evaluating the quality of life of patients. The 15-item Myasthenia Gravis Quality of Life scale (MG-QOL15) is a questionnaire utilized today to evaluate the quality of life of MG patients. Aims: To obtain a valid and reliable Indonesian version of MG-QOL15 instrument. Methods: Forty four MG patients at the Cipto Mangunkusumo Neurology outpatient clinic who met the inclusion criteria were included in this cross sectional study. Patients filled in the MG-QOL15 questionnaire twice at two days interval. The concept used for the validity test of MG-QOL15 INA is cross-cultural validation according to World Health Organization (WHO) method. Reliability test was assessed using Cronbach alpha value. Results: We performed WHO cross-cultural validation on MG-QOL15 INA and obtained Spearman correlation coefficient values ranging from 0.568-0.789 at the first examination and 0.574-0.763 at the retest. Cronbach’s alpha value at the first examination was 0.917 and 0.909 for the retest. Discussion: MG-QOL15 INA is valid and reliable to be used as an instrument in evaluating the quality of life of MG patients. Keywords: Myasthenia gravis, MG-QOL15, quality of life
DRY NEEDLING SEBAGAI TERAPI NYERI MIOFASIAL SERVIKAL Hanik Badriyah Hidayat; Annisa Oktavianti
NEURONA Vol 37 No 4 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.177

Abstract

Cervical myofacial pain (CMP) is a common source of nonspecific chronic neck pain. Pain can be local, regional and can also it has many many trigger points (trigger points / TrPs). CMP causes pain in the area of the cervical muscles and surrounding fascia. Neck pain reduces quality of life, productivity; furthermore, it also causes disability so that it affects socioeconomically towards patients and the community.Treatment of cervical myofacial pain syndrome is still unsatisfactory due to its chronicity. Dry needing (DN) is one of the nonpharmacological therapy option that can be applied in CMP. DN reduces peripheral and central sensitization by eliminating sources of peripheral nociception (MTrPs area), modulating dorsal horn activity and activating central pain inhibitory pathways.Recently, the DN therapy has been rapidly develop in pain management. However, the effectiveness of DN therapy is still unclear. Therefore, knowledge about the role of DN in CMP is important to be known. This article will discuss the role of DN in cervical myofacial pain syndrome.Keywords: Cervical myofacial pain, dry needling, myofascial trigger points, therapy
PENGGUNAAN TOKSIN BOTULINUM-A DENGAN PANDUAN ULTRASONOGRAFI SEBAGAI TERAPI SINDROM PIRIFORMIS REKUREN: SERIAL KASUS Yusak Mangara Tua Siahaan
NEURONA Vol 37 No 4 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.178

Abstract

Piriformis syndrome (PS) is a clinical syndrome with complaints of buttock pain that radiates to the unilateral side leg caused by sciatic nerve entrapment of piriformis muscle. Several therapy modalities of PS are oral, physical, intervention, and surgical therapy. Intramuscular injection therapy is an intervention therapy for patients who experience severe pain or have failed oral therapy and/or physical therapy. It generally involves the use of local anesthetics, corticosteroids or the botulinum toxin A. This study represents five cases of short-period recurrent PS in 4 females and 1 male with age variations from 32 to 43 years-old. All cases complained classic symptoms with sub-acute to chronic onset and previously had a conservative-interventional therapy. Long-term improvement (>9 months) was experienced after intramuscular botulinum-toxin-A injection with ultrasound-guided. Keywords: Botulinum toxin, injection therapy, piriformis syndrome.
PERAN MAGNETIC RESONANCE IMGAGING DALAM DIAGNOSIS DAN PROGNOSIS CEDERA MEDULA SPINALIS AKUT Reyhan Eddy Yunus; Taufik Budianto; Trifonia Pingkan Siregar; Thariqah Salamah; Ramdinal Aviesena Zairinal; Mohammad Triadi Wijaya
NEURONA Vol 37 No 4 (2020)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.179

Abstract

Spinal cord injury is a common type of injury that can be highly fatal. Clinically, spinal cord injury can be assessed using standardized physical examination scoring from International Standards for Neurological and Functional Classification of Spinal Cord Injury Patients, which is the American Spinal Injury Association (ASIA) impairment scale or often called as AIS. The results of this scoring will then be combined with magnetic resonance imaging (MRI) examination to determine the diagnosis and prognosis. In this case, we report a 20-year-old male complaining weakness in four extremities after traffic accident while driving a motorcycle. Based on neurological examination, the patient can barely feel a touch sensation and cannot move both his arms and legs at all. Cervical X-ray examination showed dislocation fracture on C5 level. Further MRI examination showed edema and spinal cord hemorrhage around fracture area. The findings of edema and spinal cord hemorrhage on MRI examination are useful in diagnosing and predicting the outcome of patient with spinal cord injury. Keywords: AIS score, MRI, spinal cord injury
HUBUNGAN ANTARA KADAR SEROTONIN SERUM DENGAN FUNGSI KOGNITIF PADA PASIEN NYERI KEPALA TIPE TEGANG KRONIS Ega Primadona; Dwi Pudjonarko; Dani Rahmawati; Endang Kustiowati; Herlina Suryawati; Trianggoro Budisulystio
NEURONA Vol 38 No 1 (2020)
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Abstract

Introduction: Chronic tension-type headache (CTTH) is a major health problem, although the previous data is very limited, especially in Indonesia. Cognitive disorders often occur in CTTH patients. In addition, stress factors (mental or physical), anxiety, depression, temperamental instability, that is, bigger emotional status are factors that can cause CTTH. Serotonin is involved in various behavioral functions, especially in the regulation of mood, aggressiveness and impulsiveness. Aim: To analyze the relationship between serotonin serum level with cognitive function on CTTH. Methods: This was a cross sectional study in the outpatient of neurological clinic dr. Kariadi Hospital Semarang between April - September 2019. The data consist ofserotonin levels, MoCA-Ina questionnaire, Hamilton Depression Rating scale (HDRS) score and Score Hamilton Anxiety Rating scale (HAM-A). Statistical analysis with fisher’s exact. Results: The data were obtained from 38 subjects which consisted of female (78.9%) and male (21.1%). There was a significant relationship between anxiety and cognitive function in CTTH. There was no significant relationship between depression and cognitive function on CTTH. Impaired cognitive function in CTTH is related to memory (90%) and executive domains (70%) in most cases. Discussion: There was no significant difference between normal and abnormal serum serotonin levels with impaired cognitive function. There was a significant association between low serum serotonin levels and anxiety in CTTH patients. There was no association between low serum serotonin levels and depression in CTTH patients. CTTH patients experienced cognitive impairments regarding memory and executive domains in most cases. Keywords: Chronic tension type headache, cognitive, MoCA-Ina, serotonin
PERBEDAAN PENGETAHUAN, SIKAP DAN PERILAKU PENDERITA, KELUARGA DAN MASYARAKAT TERHADAP EPILEPSI Suryani Gunadharma; Paranita Utama; Sobaryati Sobaryati; Ahmad Rizal; Lisda Amalia; Uni Gamayani
NEURONA Vol 38 No 1 (2020)
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Abstract

Introduction: Achievement of epilepsy treatment depends on the understanding of patients about their disease, compliance of antiepileptic drugs,family and communities support. Gender, age, level of education, socio-cultural, economic status,and environment affect epilepsy perceptiont. Aim: To analyze the difference in knowledge, attitudes, and behavior of epilepsy patients, families and communities with different sociodemographic backgrounds. Methods: This was a cross sectional comparative analytic study. Chi-square test was used for statistical analysis. Three validated questioners were used for each groups. Results: About 264 subjects were enroled consist of 88 subjects for each groups. Men and women was almost the same amount. The most age was 36-45 years, high school was the majority of the education level. The most types of job were housewive, most of the economic level is low. There were differences in knowledge, attitudes, and behavior related to epilepsy in this 3 groups based on level of education, socio-economic and employment, except for age. Male has a better behaviour towards epilepsy . Discussion: Our results similar with the study about epilepsy patients in Ethiopia, similar with study about epilepsy families in Sudan, Korea, and similar with community study in Malaysia except for age. For counseling it’s better to separate the groups regarding level of education and sosio-economic. Keywords: Attitude, behavior, epilepsy, knowledge
PENGARUH DERAJAT KEGANASAN TUMOR TERHADAP POLA GAMBARAN EEG PADA PENDERITA TUMOR OTAK PRIMER DI SUMATERA SELATAN Wilasari Novantina; Yunni Diansari; Sri Handayani; Achmad Junaidi; Aspitriani Aspitriani; Irsan Saleh
NEURONA Vol 38 No 1 (2020)
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Abstract

Introduction: Brain tumor is one of the major malignancies with high morbidity and mortality. Treatment options and prognosis in patients with primary brain tumors based on the type and degree of malignancy. Definitive diagnosis and degree of malignancy in patients with primary brain tumors obtained from histopathological features. But unfortunately, histopathological features are not always available in all primary brain tumor sufferers. Electrenefalography (EEG) examination is a non-invasive examination that can record biological activity and neuron changes in brain cells. Brain tumor itself is an abnormal mass in the brain tissue that interferes with the electrical and biological activity of normal cells in the brain. Aim: To determine the association between the degree of malignancy of brain tumors and EEG patterns in patients with primary brain tumors in RSUP Dr. Mohammad Hoesin Palembang. Methods: This was a cross sectional study. The study sample was primary brain tumor patients who had undergone surgery and had EEG record and histopathological features.Data were analysed using SPSS 22. Results: The data obtained from 36 samples consist of 30 samples of low grade brain tumor patients, and 6 high grade brain tumor patients. There was a weak correlation between the degree of malignancy with focal slowing EEG pattern (r = 0.378; p = 0.014). There was no correlation between the degree of malignancy with epileptiform discharge (r = 0.177; p = 0.281), focal slowing accompanied by epileptiform discharge (r = 0.215; p = 0.187) ) and normal EEG (r = 0.110; p = 0.506). Discussion: The focal slowing EEG pattern has a correlation with the degree of malignancy. This is due to changes in peri-tumoral metabolism which is common in brain tumors Keywords: brain tumor, eeg pattern, degree of malignancy

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