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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 Kadar Plasma Leptin dan Fungsi Kognitif pada Lanjut Usia di Jakarta Pratiwi, Sandi Puspita; Mudjihartini, Ninik; Lestari, Wiji; Prawirohajo, Pukovisa
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 3 (2024): Volume 40, No 3 - Juni 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i3.544

Abstract

Introduction: The increasing of elderly population often accopanied by a rise in cognitive disorders. Leptin is known to have a protective function against cognitive dectine in elderly. However, current finding regarding the role of leptin in cognitive function is vary, and has not been extensively discussed in Indonesia. Food record and antropometric assesment is conducted as an aditional analyses on subject. Aim: To determine the relationship between plasma leptin levels and cognitive function in the elderly in Jakarta. Methods: This is a cross sectional descriptive analytical research using purposive sampling as the sampling method. Subject are elderly residing in social welfare home, and being assessed using MOCA-INA instrument, IADL and GPAQ questionnaire, plasma leptin, body composition, antropometric and Food Record are measured. The data is analyzed through univariate, bivariate and multivariate analysis. Results: Subject characteristic of age ranging from 60-74 years, with female as the majority (67.5%), normal nutritional status (46.2%), body fat ranging from 18.10 to 57.10 %, muscele mass 20.20 to 57.50 kg. Majority of subject do not smoke, have a low education level (≤ 12 year of education), engage in moderate physical activity, and having independent functional capacity. A total of 96.2% of the subject experience cognitive impairment. Plasma leptin levels ranging from 1.4 to 8.5 ng/mL, with median of 5.9 ng/mL. There is a significant relationship between leptin levels, body mass index, body weight, total body fat, education and IADL with cognitive function in the elderly in Jakarta. Discussion: The correlation between plasma leptin levels and cognitive function in the elderly in Jakarta, shows a moderately positive correlation with r value of 0.47 and a significance of 0.000. Keywords: Cognitive function, Elderly, Leptin
Perkembangan Pendekatan Terapi Myasthenia Gravis Ar Rochmah, Mawaddah
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 3 (2024): Volume 40, No 3 - Juni 2024
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Abstract

Myasthenia gravis (MG) adalah gangguan autoimun kompleks yang memerlukan pendekatan pengobatan multifaset untuk mengelola gejala dan meningkatkan kualitas hidup. Spektrum perawatan berkisar dari terapi simptomatik hingga agen imunosupresif canggih dan intervensi bedah. Editorial ini mengulas berbagai modalitas pengobatan untuk MG, menyoroti mekanisme, aplikasi, dan hasilnya.
FENOMENA OTOT POSITIF PADA KELAINAN NEUROMUSKULAR Angelita, Michelle Cancera; Indrawati, Luh Ari; Hakim, Manfaluthy; Octaviana, Fitri; Budikayanti, Astri; Safri, Ahmad Yanuar; Wiratman, Winnugroho; Fadli, Nurul; Harsono, Adrian Ridski
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 2 (2024): Vol 40 No 2 (2024): Volume 40, No 2 - Maret 2024
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Abstract

Positive muscle phenomena arise due to various forms of spontaneous muscle hyperactivity originating from motor neurons or the muscle itself. The presence of this phenomenon can constringe the possible diagnosis to be more specific, so if presence it is necessary to be identified in patients with potential neuromuscular disease. However, the presence of positive muscle phenomena is often overlooked. This gap in our knowledge regarding definitions, clinical findings, electrodiagnostic findings, and pathophysiological mechanisms hampers effective diagnosis and treatment. In this article, we review the clinical characteristics approach to diagnosis of various positive muscle phenomena originating from the lower motor neuron (LMN) and muscle, including tetany, cramps, fasciculations, myokymia, neuromyotonia, rippling muscle, percussion induced rapid contractions (PIRCs), myoedema, and contractures. Keywords: fasciculation, muscle phenomena, hyperactivity, myotonia, rippling muscle
FAKTOR-FAKTOR YANG MEMPENGARUHI LUARAN PADA PASIEN PERDARAHAN SUBARAKHNOID: PENELITIAN COHORT PROSPEKTIF 18 BULAN Muhlisa, Safitri; Ramadhoni, Pinto Desti; Junaidi, Achmad; Octavinawaty, Lenny; Adwirianny, Ashita Hulwah
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 2 (2024): Vol 40 No 2 (2024): Volume 40, No 2 - Maret 2024
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i2.451

Abstract

Introduction: Subarachnoid hemorrhage (SAH) is an acute bleeding in the subarachnoid space. The mortality rate of SAH is quite high and survivors will experience limitations in activity daily living. Identification and factors that affect SAH are needed to improve patient outcomes. Aim: to identify the factors that affect the mortality of SAH Methods: This study was an observational study with a prospective cohort approach regarding the factors that affect the outcome of subarachnoid hemorrhagic patients in Dr. Mohammad Hoesin Hospital Palembang from January 2021 to July 2022. Results: From 62 subjects, the patients were 55.35 (SD ± 12.4) years old in average, most of them were female (67.7%). About 87.1% of patients had GCS> 8 (mean 11.68, SD ± 3.273). There were 82.3% of patients with mild-moderate NIHSS (mean 11.68; SD ± 3.273). The mortality rate was 37.1% (n = 23) with associated factors such as onset of admission (p = 0.044, GCS on admission (p= 0.003), severity of stroke (NIHSS) (p = 0.013), SAH severity (Hunt and Hess scale) (p=0.00), modified fisher scale (p=0.000), and coiling (p=0.001).The factor that most influenced the outcome was modified Fisher 3-4 (OR= 12,426, CI95% = 2,239 – 68,953) and non-coiling (OR: 12,2278, CI95% = 1,716 – 87,838). Discussion: There was a significant correlation between admission onset, GCS on admission, stroke severity (NIHSS score), modified Fisher scale, SAH severity (Hunt and Hess scale), and coiling, with the mortality of subarachnoid hemorrhage. Modified fisher scale and non-coiling were the most dominant factors that affected the mortality rate. Keywords: SAH, mortality, outcome
PROFIL PEMERIKSAAN EVOKED POTENTIAL PADA KASUS NEUROONKOLOGI DI RSUPN DR. CIPTO MANGUNKUSUMO Tejomukti, Teddy; Aninditha, Tiara
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 1 (2024): Vol 41 No 1 (2024): Volume 41, No 1 - Desember 2024
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i1.476

Abstract

ABSTRACT Introduction: Functional integrity of specified cortical areas and pathways in the central nervous system can be assessed by recording electrical potency such as Evoked Potential (EP) related to sensory or motoric events. Neoplasm can disturb functional integrity in the nervous system. Methods: This was an analytic cross-sectional research with the categorical approach in patients who underwent EP in Neurological Clinic RSUPN dr. Cipto Mangunkusumo Jakarta since 2022. Data were taken from medical records from December 2022 to March 2023. Demographic data, clinical data, neoplasm data, and EP examination data were recorded. The relation between neoplasm (type, location, number of lesions) and symptoms to EP results were analysed with Chi Square test Result: There were 660 evoked potential examinations consisting of 363 SSEP, 242 VEP and 55 BAEP examinations for various neurological clinical indications, however EP examinations indicated for neurooncology cases were 45 subjects or 6.8% of all examinations. A significant relation was found between sensory (p=0.03), motor (p=0.04), and autonomic (p=0.004) symptoms with abnormal SSEP examination results. Pain was not associated with abnormal SSEPs. No significant relationship was found between the number and location of tumors with the SSEP examination. All of the study subjects (100%) had visual disturbances and abnormal features of VEP. The BAEP examination was not analyzed because the sample size was too small. Conclusion: EP may be indicated in neurooncology cases in assessing functional lesions due to tumors, both intracranial and spinal. Keywords: Evoked Potential, nervous system neoplasm
SKOR ISAN SEBAGAI PREDIKTOR IN-HOSPITAL MORTALITY PADA PASIEN DENGAN STROKE-ASSOCIATED PNEUMONIA Mara Ditta, Adist Azizy; Gofir, Abdul; Satiti, Sekar; Hanif, Faishal
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 2 (2024): Vol 40 No 2 (2024): Volume 40, No 2 - Maret 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i2.497

Abstract

Introduction: Stroke-associated pneumonia (SAP) is attributed as the most common cause of death in acute stroke. ISAN score is a potential tool for predicting SAP in acute stroke care since it is easy to use. Several clinical risk such as age and pre-stroke disability has been proposed to contribute mortality in SAP patients. Aims: This study aims to determine the relationship between ISAN score and in-hospital mortality in acute stroke patients at RSUP Dr. Sardjito. Methods: This study is an analytic observational study with a retrospective cohort design using data from the stroke registry of the Stroke Unit of RSUP Dr. Sardjito from 2021 - 2023. Patients who were clinically diagnosed with SAP at the time of acute phase stroke treatment were included in the study. ISAN scores were divided into 0-5, 6-10, 11-14, and >14 with the interpretation of low, medium, high, and very high respectively. The data was analysed using SPSS v22.. Results: A total of 147 stroke patients with SAP (55% male, mean age 64.9 ± 13.4 years) were included in this study. Death occurred in 61 study subjects and was more prevalent in the high ISAN group (n=30). On bivariate analysis, mortality was significantly associated with ISAN score (p=0.002), gender (p=0.003) and NIHSS score (p=0.002). High ISAN scores have been associated with mortality of stroke patients with SAP, according to multivariate analysis. (aOR=3.94, IK95% 1.31-11.84, p=0.015). Discussion: A high ISAN score at admission is significantly associated with mortality of stroke patients with SAP. Keywords: Pneumonia, stroke, mortality, acute stroke, ISAN score
STROKE REKUREN PADA PASIEN ENDOKARDITIS INFEKTIF BAKTERIAL: SEBUAH LAPORAN KASUS Pangestiningrum, Dhian
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 3 (2025): Vol 41 No 3 (2024): Volume 41, No 3 - Juni 2025
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i3.506

Abstract

Pendahuluan: Endokarditis infektif (EI) merupakan salah satu penyakit yang mengancam nyawa pada dewasa. Endokarditis infektif ditandai dengan inflamasi pada endokardium dan katup jantung, utamanya oleh infeksi bakteri. Endokarditis infektif memiliki beragam manifestasi klinis dan sekuele. Pasien EI bisa datang dengan kegawatan neurovaskular seperti stroke iskemik. Pasien EI dengan stroke akut umumnya memiliki prognosis yang buruk, sehingga perlu strategi penanganan yang tepat. Laporan kasus ini membahas kejadian stroke rekuren pada pasien laki-laki dengan endokarditis infektif. Laporan Kasus: Laki-laki 72 tahun dengan keluhan utama gelisah dan bicara melantur sejak 1 minggu sebelum masuk rumah sakit. Pasien lambat jika diajak berkomunikasi. Pasien memiliki riwayat didiagnosis endokarditis sejak Juni 2023 dengan terapi rutin oleh dokter spesialis jantung. Dari pemeriksaan fisik didapatkan paresis nervus kranialis VII sinistra dengan keterbatasan gerak dan penurunan kekuatan pada ekstremitas kiri. Hasil pemeriksaan CT scan kepala menunjukkan infark akut pada nukleus kaudatus kanan sesuai teritori arteri lentikulostriata media dekstra dan arteriosklerosis pada arteri serebri media dekstra. Pasien diberi tata laksana sesuai EI. Saat perawatan didapatkan perburukan pada kelemahan ekstremitas kiri. Diskusi: Endokarditis infektif umumnya disebabkan oleh infeksi bakteri yang secara patofisiologis memicu pelepasan sitokin inflamasi dan faktor jaringan yang menyebabkan terbentuknya trombus. Trombus dapat menyebabkan emboli yang menyumbat berbagai pembuluh darah sistemik. Pembuluh darah otak adalah salah satu tempat embolisasi tersering pada EI. Komplikasi neurologi ini terjadi pada 40-50% pasien EI. Kata kunci: stroke rekuren, endokarditis infektif bakterial, infeksi
HUBUNGAN POLIMORFISME MTHFR c.677C>T DENGAN FUNGSI KOGNITIF PADA PASIEN STROKE ISKEMIK AKUT DI RSUP DR. SARDJITO Haq, Arinal; Gofir, Abdul; Ar Rochmah, Mawaddah; Amelia Nur Vidyanti; Yogik Onky Silvana Wijaya, Yogik Onky Silvana Wijaya
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 2 (2024): Vol 40 No 2 (2024): Volume 40, No 2 - Maret 2024
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i2.511

Abstract

Introduction: Ischemic stroke is an acute cerebrovascular event with cognitive impairment presents as its prevalent manifestation and complication. Methylenetetrahydrofolate reductase (MTHFR) is an important enzyme in folate metabolism through an integral process of cellular metabolism in DNA, RNA and protein methylation. MTHFR c.677C>T polymorphism is considered an important genetic risk factor for stroke and cognitive dysfunction in some populations. Aim: This study aimed to investigate the association between the MTHFR c.677C>T polymorphism and cognitive function in acute ischemic stroke patients in Dr. Sardjito General Hospital Yogyakarta. Methods: We performed a cross-sectional study in 42 consecutive acute ischemic stroke patients. PCR R-FLP was used to examine MTHFR c.677C>T polymorphism. Cognitive function was determined using MoCA-Ina within 24 hours of each patient’s admission, with score 24 is the cut off for cognitive impairment. Results: Of 42 patients, 12 patients (28.6%) showed MTHFR c.677C>T variant. There were 3 patients (25%) with homozygous variant of MTHFR c.677C>T. Cognitive dysfunction was found in 7 patients (16.7%) with MTHFR c.677C>T variant and 18 patients (42.9%) with wild type MTHFR. However, no significant association was found between MTHFR c.677C>T with cognitive function in acute ischemic stroke patients (p=0.921). Discussion: The frequency of MTHFR c.677C>T polymorphism in this study was 28.6% with a quarter of them showing homozygous variant. There was no association between MTHFR c.677C>T polymorphism with cognitive function in acute ischemic stroke patients.
MULTIPEL ANOMALI PADA DANDY-WALKER CONTINUUM: SEBUAH LAPORAN KASUS Reno Sutam,a, I Komang
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 2 (2025): Vol 41 No 2 (2025): Volume 41, No 2 - Maret 2025
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i2.519

Abstract

Dandy-Walker Continuum (DWC) adalah spektrum kelainan neurologis bawaan langka yang memengaruhi perkembangan serebelum. Kelainan yang terjadi umumnya berkaitan dengan sindroma serebelum tetapi pada kenyataannya dapat memengaruhi perkembangan otak secara luas. Dilaporkan sebuah kasus DWC pada anak usia 4 tahun, yang lahir dengan hidrosefalus komunikan dan epilepsi, yang telah menjalani operasi pemasangan VP-Shunt. Pada hasil skrining perkembangan,pasien menunjukkan suatu Global Delay Developmental (GDD) dan gangguan penglihatan. Menurut pemeriksaan funduskopi, ditemukan adanya papil atrofi primer di kedua mata. Pemeriksaan dengan flash VEP menunjukkan tidak ada respon selama stimulasi dilakukan, yang menunjang suatu agenesis nervus optic. Kelainan tersebut terjadi akibat terganggunya keseluruhan perkembangan neuron pada trimester pertama, selain itu juga akibat komplikasi cedera jaringan otak terkait hidrosefalus, hingga komplikasi dari tindakan medis yang diberikan. Oleh karena itu, sebuah tim multidisiplin akan sangat membantu dalam mengenali berbagai dampak lain dari gejala klasik DWC.
KARAKTERISTIK PASIEN SINDROM GUILLAIN-BARRÉ DI RSUP DR. M. DJAMIL PADANG TAHUN 2020-2023 Masra, Salwa Atsilah
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 1 (2024): Vol 41 No 1 (2024): Volume 41, No 1 - Desember 2024
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i1.554

Abstract

Introduction: Guillain-Barré syndrome (GBS) is a post-infectious autoimmune disease that attacks components of the peripheral nervous system and presents with the distinctive clinical feature of acute ascending flaccid paralysis. The incidence of GBS varies globally, with a notable increase observed over the past two decades. The prevalence of GBS in Indonesia, particularly in West Sumatra, has not been fully documented. Aim: To elucidate the characteristics of GBS patients at RSUP Dr. M. Djamil Padang in 2020-2023. Methods: This study utilizing the total sampling technique. It relies on secondary data in the form of medical records obtained from RSUP. Dr. M. Djamil Padang in 2020-2023. The study encompasses 52 samples that meet the inclusion criteria. Results: Predominantly GBS affects individuals aged ≥ 18 years (65%), with a male preponderance (65%). The median onset of the disease is 8 days, ranging from 1 to 56 days, while the nadir in most patients was reached within ≤ 14 days (81%). More than half of the patients had a history of preceding infections (60%). Most of the patients had clinical symptoms include weakness in both extremities (79%), hyporeflexia (65%), and negative sensory symptoms (50%). Most of them do not exhibit autonomic dysfunction (81%) or cranial nerve dysfunction (63%). Over half of the patients show cytoalbuminologic dissociation (56%). More than half of the patients were identified as AMSAN subtype (56%), with over half of the patients experiencing a severity score of 4 (54%). Corticosteroids were the primary therapeutic regimen received by most of the patients (54%). Discussion: The outcomes of this study contribute valuable information and support enhanced diagnostic and management efforts. Keywords: Characteristics, Guillain-Barré Syndrome, GBS

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