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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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TANTANGAN DIAGNOSTIK DAN PENATALAKSANAAN NEUROMYELITIS OPTIC SPECTRUM DISORDER: SEBUAH SERIAL KASUS Luthffia, Audiza; Asmedi, Ahmad; Harahap , Indra Sari Kusuma; Yudiyanta, Yudiyanta
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 2 (2025): Vol 41 No 2 (2025): Volume 41, No 2 - Maret 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i2.599

Abstract

Introduction: Neuromyelitis optic spectrum disease (NMOSD) is a rare inflammatory CNS disorder consisting of simultaneous optic neuritis and transverse myelitis. The diagnosis requires combinations of clinical characteristics, serologic testing of Aquaporin-4 (AQP4) antibody, and neuroimaging. Treatment includes steroids, plasma exchanges and immunosuppressants. Despite of treatment, NMOSD can lead to devastating sequelae and complications in unresponsive cases. Case Report: We report three cases of adult women with AQP4-antibody positive NMOSD. First case was referral from regional hospital with bilateral visual loss preceded by tetraparesis with relapse and remitting period since 4 years before admission. Second case was referral from regional hospital with persistent right eye visual loss 3 years before admission with acute left eye visual loss and paraparesis. Third case directly admitted to Dr. Sardjito Hospital with acute unilateral visual loss and tetraparesis. Plain head CT scan was performed in the first two cases with normal result and spinal cord MRI in all patients showed long extensive transverse myelitis. All patients received high dose IV Methylprednisolone with immunosuppressant either azathioprine or mycophenolic acid, and continued with plasma exchange for the first two patients. There was no significant improvement in all patients following therapy. Conclusion: All three cases had manifestations of optic neuritis and transverse myelitis, and two of them was referral from regional hospital. Limited access to AQP4-antibody testing and MRI remains a challenge in NMOSD diagnosis, which can lead to delayed in diagnosis. Clinician should suspect for NMOSD in the presence of optic neuritis and myelitis manifestations.
Hubungan Antara Lokasi Lesi Pada Stroke Akut Terhadap Kejadian Disfagia Di RSUD Dr. Saiful Anwar Provinsi Jawa Timur Kartika Sari, Wahyu Dwirima
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 2 (2025): Vol 41 No 2 (2025): Volume 41, No 2 - Maret 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i3.600

Abstract

Introduction: Dysphagia is a common complication following acute stroke, occurring in approximately 28-65% of cases and posing significant risks such as aspiration, pneumonia, and prolonged hospitalization. Previous studies have identified associations between acute stroke and dysphagia, implicating various brain regions. Aim: This study aimed to explore the correlation between lesion location and dysphagia in acute stroke patients treated at RSUD Dr. Saiful Anwar, East Java. Metode: The study employed the Swallowing Swallowing Screening (GUSS) questionnaire to detect dysphagia in acute stroke patients. Lesion location analysis utilized the chi-square test to differentiate between strategic and non-strategic areas. Results: Data from July to September 2023 included 35 samples, comprising 22 males (62.9%) and 13 females (37.1%). Ischemic stroke accounted for 25 cases, while hemorrhagic stroke accounted for 10. Among ischemic stroke patients, only one exhibited dysphagia, compared to two in the hemorrhagic stroke group. These findings align with prior research, indicating a higher prevalence of dysphagia in hemorrhagic strokes, particularly those involving the cerebral hemisphere and intraventricular extension. Statistical analysis using the Fisher Test did not demonstrate a significant association between lesion location and dysphagia in either ischemic or hemorrhagic strokes (p > 0.05). Discussion: This study found no significant relationship between lesion location and dysphagia incidence in acute stroke patients at RSUD Dr. Saiful Anwar. Further research with a larger sample size is warranted to validate these findings and explore additional factors influencing post-stroke dysphagia. Keywords: Dysphagia, GUSS (Gugging Swallowing Screen), acute stroke, lesion
Pengaruh Pemberian Terapi rTMS dengan Kualitas Tidur Pasien Post Stroke Iskemik Desfarina, Desfarina
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 1 (2024): Vol 41 No 1 (2024): Volume 41, No 1 - Desember 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i3.602

Abstract

ABSTRACT Background: Stroke is the second leading cause of death and disability in the world. One of the complications of stroke is sleep disorders. Apart from medication, repetitive Transcranial Magnetic Stimulation (rTMS) is an alternative therapy for managing sleep disorders. Objective: This study aimed to assess the effect of rTMS therapy on the sleep quality of post ischemic stroke patients at RS Dr. M. Djamil Padang. Method: This analytical observational study utilized a cross sectional design conducted at the Neurological Polyclinic of RS Dr. M. Djamil Padang from August 2023 to February 2024. Samples were taken using consecutive sampling techniques based on inclusion and exclusion criteria. High frequency rTMS stimulation was administered to the left DLPFC (dorsolateral prefrontal cortex) 10 times. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The influence between research variables was tested bivariate using the T test, Mann-Whitney test, Fisher test, and McNemar test. Results: The average PSQI score in patients before rTMS therapy was 9.83±3.996, and after rTMS therapy was 4.13±3.327. Based on the results of bivariate analysis, there is a significant effect between giving rTMS therapy and improving sleep quality in post ischemic stroke patients with a value of p<0.001. Discussion: Post ischemic stroke patients who underwent rTMS therapy experienced a decrease in average PSQI score with a mean difference of 5.70, and most patients had good sleep quality after undergoing rTMS therapy in this study (75%). Giving high frequency rTMS to the left DLPFC enhances cortical and subcortical stimulation, thereby improving sleep quality. Keywords: rTMS, sleep quality, stroke, PSQI.
PERAN ANALISIS SUARA DALAM DETEKSI DINI KOGNITIF PADA LANSIA: STUDI PENDAHULUAN Kristian, Kevin; Adhitya, Paskalis; Tirta Wening, Andrea; Indrawan, Novelya; Indrajaya, Feryandinata; Yauw, Michael
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 4 (2025): Volume 41 Nomor 4, September 2025
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i4.615

Abstract

ABSTRACT Introduction: The increase in life expectancy makes the cognitive abilities of the elderly important. The need for a rapid diagnosis of cognitive impairment renders the currently available instruments inadequate. Standardization of the use of voice analysis for cognitive assessment is required for quick diagnosis. Aim: To determine the relationship between voice components and cognitive impairment in the elderly. Methods: A descriptive and analytical cross-sectional study was conducted on elderly individuals over 60 years old who did not have visual or hearing impairments. Cognitive assessment using MoCA-INA was performed on 107 elderly individuals who met the inclusion criteria and were categorized into normal and cognitively impaired groups. Results: The majority of the study respondents were aged 61-70 years (57.9%), not frail (93.5%), had multimorbidity (60.74%), had a habit of exercising (66.4%), and had a formant frequency 1 (F1) of the vowel /e/ <500.9 Hz (50.5%). Univariate analysis showed that F1 of the vowel /e/ had very high variability (107041.294), and the compare means analysis showed a significant relationship (p=0.034). Discussion: Most of the elderly in this study did not have cognitive impairment. There was a relationship between F1 of the vowel /e/ and cognitive impairment at a MoCA-INA cut-off score of 22. There was no relationship between age, exercise habits, multimorbidity, fundamental frequency of the vowels /a/ and /e/, amplitude of the vowels /a/ and /e/, F1 and F2 of the vowel /a/, and F2 of the vowel /e/. Keywords: cognitive impairment, elderly, formant 1 (F1), voice analysis
SINDROMA NEUROLEPTIK MALIGNA: LAPORAN KASUS JARANG said, sari
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 2 (2025): Vol 41 No 2 (2025): Volume 41, No 2 - Maret 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i2.630

Abstract

ABSTRACT Background: Malignant Neuroleptic Syndrome (SNM) is a rare syndrome, around 0.01% to 3.3%, patients who experience SNM are often occurring at a young age male (2:1). SNM has 4 symptoms, namely hyperpyrexia, muscle rigidity, mental changes, and autonomic instability. Case Report: MI, 16 years old, with slurred speech 3 days before going to the hospital. The patient had a history of being hospitalized with a psychiatrist for 2 days with Risperidone 2x1mg and Haloperidol 2x5mg as home medications. There are significant findings in leukocytosis (19,500) and an increase in liver enzymes (SGPT 65). On the 7th day of treatment, the patient who was initially rowdy, restless, and spoke slurred suddenly experienced symptoms of being unable to move, drooling a lot accompanied by not being able to swallow, then haloperidol 2x2.5mg was stopped and showed a gradual improvement in his condition. Discussion: Malignant neuroleptic syndrome is rare but can cause morbidity and mortality. On MI examination there was leukocytosis (19,000) and an increase in liver enzymes (SGPT 65), this is to research conducted by Micheal Kiyingi, et al. (2020) which states that patients diagnosed with SNM will experience leukocytosis and elevated liver enzymes. There are no guidelines for the management of SNM, but our patient stopped taking risperidone and haloperidol and gradually improved clinically. This is to the research of Ling Deng, et al (2022) which stated that risperidone and haloperidol can cause SNM, so, in the treatment of SNM, these drugs must be discontinued. This case shows that early and appropriate diagnosis and management in SNM cases are very important to obtain good clinical outcomes and avoid misdiagnoses that result in disability and death. Keywords: Malignant Neuroleptic Syndrome, antipsychotic, pediatric
Hubungan Kualitas Tidur terhadap Kejadian Migrain pada Mahasiswa Preklinik Universitas Katolik Indonesia Atma Jaya Caldino, Aiko; Tanti Narwati, Yulia; Kristina Sasmita, Poppy
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 2 (2025): Vol 41 No 2 (2025): Volume 41, No 2 - Maret 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i2.644

Abstract

Introduction: Headache is ranked the third highest cause of years lived with disability (YLD). Out of 46.6 million cases of YLD, migraine constitutes approximately 88.2%. As one of the drivers of migraine, poor sleep quality is often found among preclinical students who are still adapting to a more demanding academic schedule. This study aims to explore the association between sleep quality and migraine in preclinical students of Atma Jaya Catholic University of Indonesia.Method: This analytical cross-sectional study includes 212 preclinical students of Atma Jaya Catholic University of Indonesia from batch 2020, 2021, and 2022. Standardized questionnaires, such as the Pittsburgh Sleep Quality Index (PSQI) and Migraine Screen Questionnaire (MS-Q) were utilized to collect the participants’ sleep quality and migraine characteristics. Samples were taken by simple random sampling with Chi-square test.Results: Among 212 preclinical students, 109 (51,4%) students have poor sleep quality, and 55 (25,9%) students experience migraine. This study observed a significant relationship between sleep quality and migraine in preclinical students of Atma Jaya Catholic University of Indonesia with p-value <0.001.Conclusion: There is a significant relationship between sleep quality and migraine in preclinical students of Atma Jaya Catholic University of Indonesia on batch 2020, 2021, and 2022.Keywords: Migrain, preclinical students, sleep quality
HUBUNGAN USIA DAN JENIS KELAMIN DENGAN KEJADIAN STROKE DI RSUD KHZ MUSTHAFA TASIKMALAYA 2023 nurul, nasyifa
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.v41i2.646

Abstract

ABSTRACT Introduction: According to the 2018 Riskesdas data, the prevalence of stroke in Indonesia indicates a potential global increase in the coming years as the population ages. Based on gender characteristics, the prevalence of stroke in males is 8.8%, and in females, it is 7.9%, showing only a slight difference, with males being slightly more susceptible to stroke. Aim: To determine the relationship between age and gender characteristics with the incidence of stroke at KHZ Musthafa General Hospital, Tasikmalaya, in 2023. Method: This study uses a retrospective observational design. Data were obtained through secondary data in the form of medical records of patients who were hospitalized at KHZ Musthafa General Hospital in 2023. The sample was taken using total sampling. Data were tested using the chi-square test. Results: The highest number of ischemic and hemorrhagic stroke patients was found in the 45-64 age group. Hemorrhagic stroke occurred more frequently in females, while the incidence of ischemic stroke was similar between males and females. Discussion: There is a very significant relationship between age and the incidence of both hemorrhagic and ischemic stroke. Individuals over the age of 45 have a 12-fold higher risk of hemorrhagic stroke and a 24-fold higher risk of ischemic stroke compared to those under 45. Gender does not have a significant relationship with the incidence of hemorrhagic stroke, while for ischemic stroke, females show a lower risk compared to males. Keywords: Age, Gender, Stroke
Perbandingan Keputusan Rujuk Pasien Stroke Baru Dengan Pasien yang Pernah Didiagnosis Sebelumnya Pada Layanan Telemedis Prawiroharjo, Pukovisa; Kurniawan, Mohammad; Alexander, Fooann
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.v41i3.665

Abstract

ABSTRACT Introduction: Stroke is the third leading cause of death worldwide. Unfortunately, the high incidence of stroke in Indonesia is not matched by prompt and effective treatment, resulting in a high disability rate. These limitations make decision-making in telemedicine services challenging. Objective: This study aims to compare decision-making related to stroke management between newly diagnosed patients and those previously diagnosed. Methods: This study employed a cross-sectional retrospective design. The data consisted of 256 secondary data obtained from telemedicine company conversations during March and April 2020. Patients were categorized into newly diagnosed stroke patients and previously diagnosed stroke patients. Results: Among the 256 subjects, a significant relationship was found between patient status and decisions regarding referral and pharmacological management. Newly diagnosed stroke patients more frequently received referral decisions, while previously diagnosed patients more often received pharmacological management. Discussion: This study indicates a significant association between patient status and decisions on referral and pharmacological management in telemedicine services. Further studies with larger sample sizes and longer time periods are needed for better representation of conditions in Indonesia. Keywords: patient status, pharmacological treatment, referral, stroke, telemedicine.
PROFIL KLINIS DAN LUARAN PASIEN STROKE-ASSOCIATED PNEUMONIA (SAP) DI RSUD ARIFIN ACHMAD PROVINSI RIAU Juananda, Desby; Sukiandra, Riki; Maryanti, Yossi; Sucipto, Sucipto; Rahmata Illahi, Annisa; Luo Putra Fau, Joyada; Muslimah Syahrianti, Ukhty
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

Abstract

Introduction: Stroke-associated pneumonia (SAP) is a post-stroke complication that increases morbidity and mortality. Aim: This study aims to examine the clinical characteristics and outcomes to facilitate appropriate clinical decision-making for the treatment and prevention of post-stroke complications. Methods: This cohort retrospective study utilizes medical records of SAP patients at RSUD Arifin Achmad from July 2019 to June 2024. The populations were patients who have developed pneumonia within 48 hours to 7 days after stroke onset. Results: Out of 1,040 stroke patients, 108 (10.4%) developed SAP, with 66.7% classified as definite cases and 33.3% as probable cases. Patients in the ≥60 age group accounted for the highest number of cases (54.6%), with a male-to-female predominance of 64.8%. SAP occurred more frequently in ischemic stroke (68.5%) compared to hemorrhagic stroke (31.5%). Most SAP patients required mechanical ventilation (52.8%). SAP patients required hospitalization, with 45.4% staying for ≤14 days and 53.7% for >14 days. Regarding comorbidities, SAP patients also suffered from hypertension (54.1%), followed by other comorbidities such as diabetes mellitus, chronic obstructive pulmonary disease (COPD), and atrial fibrillation (AF). The blood glucose levels upon hospital admission indicated that SAP patients had a glucose distribution range of 80-144 mg/dl (53.7%), 145-179 mg/dl (14.8%), and ≥180 mg/dl (31.5%). The mortality rate was 57.4%, resulting in 62 deaths. Discussion: This study reveals a significant incidence of SAP in older male stroke patients, especially those with ischemic strokes. The strong association to ventilator use and mortality rates emphasizes the need for early identification and management strategies.
Neuromuscular Taping Decompression Technique in Diabetic Painful Polyneuropathy: Impact on Pain Intensity Harun Muchsin, Achmad; Blow, David; Goysal, Yudy; Wuysang, Audry Devisanty; Tammasse, Jumraini; Bahar, Ashari; Zainuddin, Andi Alfian; Walenna, Nirwana Fitriani
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 3 (2025): Vol 41 No 3 (2024): Volume 41, No 3 - Juni 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i3.679

Abstract

Background: This study aimed to evaluate the effects of neuromuscular taping decompression technique (NMT) on modifying pain scale in diabetic patients with painful distal symmetrical polyneuropathy (DSPN) at Wahidin Sudirohusodo Hospital, Makassar, Indonesia. Using a pure experimental design with a pre-test and post-test control group method, 30 patients were included: 15 in the treatment group and 15 in the control group. The treatment group received decompression NMT on the dorsal and plantar aspects of the foot twice a week for four weeks, along with vitamin B complex supplementation. The control group received only vitamin B complex. Result: The Mann-Whitney test showed significant improvement (p <0.05) in the pain scale of the treatment group on day 28, with the Numeric Pain Rating Scale (NPRS) score being lower than that of the control group. Conclusion: This study demonstrated the significant pain-reducing effect of NMT in DSPN patients. The combination of vitamin B1, B6, and B12 supplementation with 8 NMT sessions over 28 days reduced pain to 0 on the NPRS scale. Treatment twice a week for 4 weeks, alongside vitamin B, led to near-zero pain, with pain-free results expected after 5 treatments over 17 days. NMT combined with vitamin B reduced pain approximately 2 times faster than vitamin B alone. Keywords: Diabetic Painful Distal Symmetrical Polyneuropathy, DSPN, Diabetic Neuropathic Pain, Neuromuscular Taping, NMT

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