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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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RASIO NEUTROFIL LIMFOSIT SEBAGAI PREDIKTOR LUARAN KASUS CEDERA KEPALA SEDANG DAN BERAT: STUDI MULTISENTER Hanif Gordang Tobing; Yovanka Naryai Manuhutu; Syaiful Ichwan; Renindra Ananda Aman; Setyo Widi Nugroho; Samsul Ashari; David Tandian; Mohammad Saekhu; Wismaji Sadewo; Affan Priyambodo; Kevin Gunawan; Ande Fachniadin
NEURONA Vol 38 No 3 (2021)
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Abstract

Introduction: Traumatic brain injury (TBI) is the most common cause of death in populations less than 40 years old in developed and developing countries. The clinical outcome after TBI is still an issue and difficult to predict. Besides Glasgow Coma Scale (GCS), neutrophil to lymphocyte ratio (NLR) as one of the neuroinflammation biomarkers also can predict outcomes after TBI Aim: To measure the association between NLR and GCS as predictors of moderate and severe TBI outcomes. Methods: This prospective study included moderate and severe TBI patients who underwent craniotomy in a multicenter hospital from November 2019 to November 2020. Chi-square analytic test was used to determine the relationship between demographics, clinical symptoms, NLR and GCS as predictors outcome of moderate and severe TBI. Results: About 54 patients with moderate and severe TBI consist of 41 (75.9%) male and 13 (24.1%) female patients, mean age 27.6 ± 15.3 years, preoperative GCS is 13 (7 - 13), with asymmetric pupil 33 (61.1%), seizures 5 (9.3%), hemiparesis 1 (1.86%), and GCS postoperative on the fifth and seventh day is 14 (6 - 15). Preoperative NLR was 7.4 (1.9-26.2), the cut-off for NLR as a predictor for improved GCS was at 9.8 with a specificity and sensitivity of 87%. Discussion: Low NLR had an association with the patient’s improved GCS, while a high NLR had an association with a non-improving GCS, so that the relationship between RNL and GCS could be used as an outcome predictor of moderate and severe traumatic brain injury patient. Keywords: glasgow coma scale, neutrophil to lymphocyte ratio, predictor, traumatic brain injury
HUBUNGAN FAKTOR SOSIODEMOGRAFI TERHADAP SKOR QUALITY OF LIFE IN EPILEPSY INVENTORY-10 PASIEN EPILEPSI DEWASA DI RSUD DR. SOETOMO Dwiastri Iris Sarwastuti; Paulus Sugianto; Hanik Badriyah Hidayati; Azimatul Karimah
NEURONA Vol 38 No 3 (2021)
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Abstract

Introduction: Several socio-demographic factors, such as age, sex, marital status, level of education, and employment status can determine adult epilepsy patients’ quality of life, which Quality of Life quantitively presents in Epilepsy Inventory-10 (QOLIE-10) score. Aim: This study was to understand the correlation between age, sex, marital status, level of education, and employment status on adult epilepsy patients’ QOLIE-10 score at Soetomo General Hospital. Methods: Analytical observational study using accidental sampling of adult epilepsy patients at Soetomo General Hospital in June 2019-December 2019 was implemented. Several socio-demographic factors were obtained, including age, sex, marital status, level of education, employment status, and their QOLIE-10 score calculation. Correlation analysis against the QOLIE-10 score was carried out, including the Spearman test for socio-demographic factors of age and level of education; and the Mann-Whitney test for socio-demographic factors of gender and marital status, and employment status. Results: Obtained a total of 47 samples with the most common characteristics such as aged 18-25 years (29.8%), male (53.2%), married (57.4%), had the last educational level in senior high school (68.1%), and unemployed (68.1%). Correlation analysis showed an insignificant relationship between age, sex, marital status, recent education, and employment status on the QOLIE-10 score of adult epilepsy patients (p≥0.05). Discussion: Age, sex, marital status, recent education, and employment status did not show a significant relationship to the QOLIE-10 score of adult epilepsy patients. Keywords: epilepsy, QOLIE-10
UJI DIAGNOSTIK ICE PACK TEST DAN REPETITIVE NERVE STIMULATION SERTA KOMBINASINYA PADA MIASTENIA GRAVIS Winnugroho Wiratman; Bazzar Ari Mighra; Fitri Octaviana; Astri Budikayanti; Luh Ari Indrawati; Triana Ayuningtyas; Ahmad Yanuar Safri; Manfaluthy Hakim
NEURONA Vol 38 No 3 (2021)
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Abstract

Introduction: Diagnosis of myasthenia gravis (MG) is based on clinical symptoms, physical examination and supporting examination; so far, no examination has become the primary standard in the enforcement of MG. Supporting examinations that are fast, non-invasive and easy to do are ice pack test (IPT) and repetitive nerve stimulation (RNS). Aims: To find the sensitivity and specificity of the IPT, RNS examination, and the combination of both in enforcing the diagnosis of MG. Methods: This study was conducted with a cross-sectional design using primary data and medical records of suspicious MG patients with ptosis in Cipto Mangunkusumo General Hospital between July-November 2019. Results: Of the 38 subjects with ptosis, 35 subjects were confirmed MG with positive SF-EMG/AChR antibodies/response therapy. The ice pack test was positive in 29 subjects (76.3 %). The diagnostic test results of the ice pack test have sensitivity 80%, Specificity 66.67%, area under the curve (AUC) value of 73.3%, the RNS has a sensitivity of 60%, specificity 100%, AUC value 80%, while the combination test has sensitivity 94.28%, specificity 66.67% and AUC value 80.5%. Discussion: The combination of IPT and RNS has good diagnostic value so it can be used as a supporting examination to the diagnosis of MG. Keywords: diagnostic test; ice pack test; myasthenia gravis; ptosis; RNS
MANAJEMEN NON-OPERATIF ABSES SEREBELLUM Putri Irsalina; Paulus Sugianto
NEURONA Vol 38 No 3 (2021)
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Abstract

A brain abscess is a severe infection that needs to be treated early. The increased mortality for brain abscesses is caused by modern diagnostic imaging and antibiotics that can penetrate into the central nervous system and abscesses. A cerebellar abscess was reported, with the chief complaint of chronic progressive headache. Head contrast magnetic resonance imaging (MRI) results show the presence of a right cerebellar abscess with a source of infection with otitis media and mastoiditis. Prover antibiotics and contrast head MRI evaluation show resolution of abscess diameter. Keywords: Cerebral abscess, cerebellar abscess, otitis media
NEUROMIELITIS OPTIK DENGAN ANTIBODI IGG-AQP4 SERONEGATIF Astra Dea Simanungkalit; Vivien Puspitasari
NEURONA Vol 38 No 3 (2021)
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Abstract

Optic neuromyelitis (NMO), also known as Devic’s disease, is an autoimmune disease that results in recurrent demyelination of the central nervous system, particularly the optic nerve and spinal cord. The IgG antibody is an antibody that has high specificity for NMO-SD and plays an important role in the disease course. However, in a minority of cases, there are patients with NMO-SD with seronegative results. This article reports a case of a woman with an NMO-SD diagnosis without IgG-AQP4 antibodies. Keywords: Devic’s disease, IgG-AQP4, neuromyelitis optic, seronegative NMO
MANAJAMEN SPASTISITAS PALSI SEREBRAL MENGGUNAKAN TEKNIK SELECTIVE PERCUTANEOUS MYOFASCIAL LENGTHENING Prastiya Indra Gunawan; Muhammad Rizki Darmawan M; Riza Noviandi
NEURONA Vol 38 No 3 (2021)
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Cerebral palsy (CP) is a condition of a permanent and non-progressive defect in the brain that occurs at an early age. It interferes with brain development and shows abnormalities in position, muscle tone and motor coordination, and other neurological disorders. ????ecent diagnostic guidelines state that cerebral palsy can be established early. The first step in diagnosing cerebral palsy is identifying risk factors. Intervention in the structure and function of the body is the main domain in managing cerebral palsy. This intervention aims to correct anatomical structural abnormalities that can interfere the body function. Spasticity is the most common anatomical structural abnormality found in cerebral palsy. The Selective percutaneous myofascial lengthening (SPML) technique is helpful as a minimally invasive procedure that treats spasticity with more minor complications than conventional surgical techniques. Keywords: cerebral palsy, selective percutaneous myofascial lengthening, spasticity
FAKTOR RISIKO KEJADIAN NYERI PUNGGUNG BAWAH PADA SOPIR OJEK ONLINE MOBIL Arinta Puspita Wati; Dennis Adi Purnama; Maria Belladonna Rahmawati; Trianggoro Budisulistyo
NEURONA Vol 38 No 3 (2021)
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Introduction: Low back pain (LBP) is one of the musculoskeletal problems that lead to disability, decreased productivity, and quality of life that usually happens among workers, employees, or drivers. An increase in demand using online car taxi services may lead to LBP. Aim: This preliminary study aims to determine the risk factors for LBP in online car taxi drivers. Methods: This observational analytic study was conducted using a cross-sectional design towards online car taxi drivers aged 25-64 years old in Semarang, with a minimal sample (n=15) calculated by the Lemeshow equation. The inclusion criteria for the sample in this study, i.e. online car-male taxi drivers who experience LBP, while the exclusion criteria were history of lumbar trauma or musculoskeletal disease. Data were taken by primary data, the Modified Oswestry Disability Index (MODI) questionnaire, and the numerical rating scale (NRS); then, the data were analyzed using Chi-square and logistic regression test. Results: Crosstabs showed an association of LBP with a period of working (p=0.011) and pain disability (p=0.017). At the same time, body mass index (BMI), physical activities, and exercise habits (p=0.231, p=0.168, and p=0.462, respectively) had no significant result on LBP in online car taxi drivers. Discussion: Risk factors for LBP in online car taxi drivers were a period of working and pain disability. Risk factors of BMI, physical activities, and exercise habits were not statistically significant.
HUBUNGAN PERUBAHAN SUHU TUBUH DENGAN DISABILITAS NEUROLOGIS PADA AKTIVITAS HARIAN PASIEN STROKE ISKEMIK DEFISIT NEUROLOGIS Belinda Susanto; Poppy Kristina Sasmita; Bryany Titi Santi
NEURONA Vol 38 No 3 (2021)
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Introduction: Stroke is damage to the brain from interruption of its blood supply caused by an occluded or ruptured blood vessel. Many factors can affect the neurologic outcome, such as body temperature. Higher body temperature has an unfortunate effect on neuron cells’ structure and function. Cell death would increase with increasing exposure to high body temperature.Aim: To determine the relationship between changes in body temperature with neurological deficit in ischemic stroke patients. Methods: This study is a systematic review that uses articles from 2010 to 2020. The search of the articles is conducted by three different databases, ProQuest, PubMed, and Science Direct, with pre-determined keywords. Two researchers reviewed the articles using the Newcastle Ottawa Scale with a maximum score of 9. In the end, six studies are used as the sample of this research. The neurological deficit is scored by the Modified Rankin Scale and the National Institute of Health Stroke Scale (NIHSS) on day 90. Results: Six studies fulfilled the criteria for the literature search and were assessed as having good quality based on NOS. Out of six studies, five studies stated a relationship between the changing of body temperature and neurological deficit in ischemic stroke patients. Only one study stated the opposite. Discussion: This systematic review study shows that there is an association between the changing in body temperature and neurological deficit in ischemic stroke patients, that is, an increase in body temperature can worsen neurological deficit.
FAKTOR-FAKTOR YANG MEMPENGARUHI KEJADIAN KEMATIAN PADA PASIEN MENINGITIS DI RSUP DR. MOH. HUSEIN PALEMBANG Dewie Susan; Irfanuddin Irfanuddin; Andika Okparasta
NEURONA Vol 38 No 3 (2021)
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Introduction: Meningitis is a universal health problem and a medical emergency, with high morbidity and mortality. The meningitis mortality rate is still relatively high even though more sensitive antibiotics have been given, better intensive care, advances in neurosurgery techniques, and advances in neuro-diagnostic and laboratory technology. Aims: To identify the risk factors that infuence the incidence of death in meningitis patients and to analyze the survival rate of meningitis patients admitted to dr. Moh. Husein Palembang Hospital. Methods: This study was an analytical observational study using a prospective cohort method from April to November 2020. Sampling was carried out by consecutive sampling. This study will observe mortality at the end of hospitalization and 90 days after hospitalization. Results: Of 19 study subjects, 12 subjects were alive, and seven died until the end of the observation. In bivariate analysis, infuencing factors were GCS score ≤ 11, cranial nerve paresis, cerebrospinal fuid culture, and abnormal head CT scan. In multivariate analysis, the most infuential factor was the GCS score ≤ 11 (p = 0.003). Mmeanwhile, the mean incidence mortality of bacterial meningitis occurred on day 6.5 ± 7.68, for tuberculous meningitis on day 22.5 ± 24.74, for fungal meningitis on day 68, while viral meningitis did not show any mortality.Discussion: Decreased consciousness is the leading risk factor that infuences the incidence of death in meningitis patients. Keywords: meningitis, mortality, survival analysis.
KEGIATAN KEAGAMAAN, RISIKO VASKULAR, APOΕ ε4 , DAN HUBUNGANNYA DENGAN PENURUNAN FUNGSI KOGNITIF LANSIA PENDIDIKAN RENDAH Sagita Pratiwi Sugiyono; Yuda Turana; Yvonne Suzy Handajani; Nelly Tina Widjaja; Linda Suryakusuma
NEURONA Vol 38 No 4 (2021)
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Introduction: The prevalence of lower education elderly in Indonesia is still high, while low education is one of the significant risk factors in cognitive decline. Besides, many other factors are still controversial with cognitive decline. Aim: This study focuses on religious activities, vascular risk, apolipoprotein E (APOE) ε4, and their association with cognitive decline in the elderly who already have a vital risk factor: low education. Methods: This was a cohort study. There were 154 participants of lower education elderly, with the median follow up 2-3 years. The independent variables were religious activity, vascular risk, APOE ε4, and demographic characteristics. The dependent variable was cognitive decline, defined by lowered MMSE score ≥2 compared to the baseline data. Results: The mean age of the participants was 70.5±7.9 years old, with the majority being female (73.4%). Religious activity and cholesterol level had a significant association with cognitive decline in lower education elderly (p<0.05; RR=1.6; RR=1.5), other factors, such as APOE ε4, gender, age, marital status, hypertension, body mass index, diabetes mellitus, smoking, and depression showed no significant association (p>0,05). In multivariate analysis, cholesterol level and religious activity were associated with cognitive decline with a relative risk of 2.97 and 2.3, respectively. Discussion: High cholesterol level (≥200 mg/dL) and participation in religious activity were protective factors for cognitive decline in lower education elderly.

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