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Acta Neurologica Indonesia
Published by Universitas Indonesia
ISSN : -     EISSN : 30326303     DOI : https://doi.org/10.69868/ani.v2i02
Core Subject : Health, Science,
Medicine & Pharmacology Neuroscience Public Health
Acta Neurologica Indonesia is the official publication of the Department of Neurology, Faculty of Medicine, Universitas Indonesia under Directorate of Administration, Data, and Product Management of Research and Innovation Universitas Indonesia. This journal is published in trimonthly cycle with e-ISSN: 3032-6303. The Journal aims for continuous dissemination of updates in relation to neurology and its related fields in the form of original articles, case reports and reviews.
Arjuna Subject : Kedokteran - Neurologi Klinis
Articles 7 Documents
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Search results for , issue "Vol. 2 No. 02 (2024): Acta Neurologica Indonesia" : 7 Documents clear
The Comorbidity Profile of Neurological Disease in Elderly in the Taman Sari Public Health Center from January to December 2023 Yulianti, Ika; Banu, Syairah
Acta Neurologica Indonesia Vol. 2 No. 02 (2024): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v2i02.18

Abstract

Background: The burden of neurological diseases in elderly patients is often underestimated. Therefore, our study aimed to investigate the comorbidity profile of NDs in patients aged 60 years or older at the Taman Sari Public Health Center. Method: This was a retrospective, descriptive study with a cross-sectional design. The data were collected from medical records (e-puskesmas) and SIPTM (Non-Communicable Diseases Surveillance Information System) at the Taman Sari Public Health Center from January to December 2023. The study focuses on patients diagnosed with chronic diseases who also have comorbidities of NDs. Result: Analysis was conducted on 803 individuals, including 382 males and 421 females which revealed that 68.4% of the participants had polyneuropathy, 26.8% were diagnosed with cerebrovascular disease, 2.1% had CNS infection, 1.1% had CNS metabolic disorders, 1.6% of patients exhibited symptoms of dementia. Discussion: The study has shown that polyneuropathy is a prevalent issue, with cerebrovascular diseases exhibiting intermediate to high levels of patient comorbidity. CNS infection with tuberculosis meningitis is the leading cause of CNS infection. Furthermore, metabolic diseases can cause CNS metabolic disorders, while dementia is often associated with patient comorbidity, which significantly influences its clinical progression. Conclusion: Understanding the comorbidity profile of neurological diseases in elderly patients at the Taman Sari District Health Center could improve patient care management and lead to better outcomes.
The Effectiveness of Plasmapheresis Compared to Intravenous Immunoglobulin in Guillain-Barre Syndrome Patients Mustika, Alyssa Putri; Hakim, Manfaluthy; Sari, Waode Satriana; Octaviana, Fitri; Budikayanti, Astri; Safri, Ahmad Yanuar; Wiratman, Winnugroho; Indrawati, Luh Ari; Fadli, Nurul; Harsono, Adrian Ridski; Savitri, Irma
Acta Neurologica Indonesia Vol. 2 No. 02 (2024): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v2i02.24

Abstract

Introduction : Guillain-Barré syndrome (GBS) is the second most common cause of acute and subacute general paralysis. The management is symptom-adjusting, but plasmapheresis (plasma exchange/PE) and intravenous immunoglobulin immunotherapy (IVIG) can be administered to accelerate the return of neurological function. This study aim to determine PE's effectiveness compared to IVIG in GBS patients and the side effects or complications that may arise. Method : The literature study is carried out on four databases. Selection is carried out using inclusion and exclusion criteria. The articles were screened and extracted independently by two investigators. Results : The literature study obtained three systematic review studies. In the first study, shows the outcomes in the form of improved Hughes Score (OR 1.9; 95% CI 1.11-3.28) and mortality (OR 0.8; 95% CI 0.31-2.29) against IVIG. The second study, outcomes shown in the form of improved disability scores (WMD -0.02, p: 0.83), and secondary outcomes such as mortality or relapse (p >0.05, respectively). The third study showed that IVIG had higher efficacy (OR 1.6, p: 0.067, 95% CI 0.972-2.587), shorter duration of hospitalization, 38 days, compared to 49-day PE therapy (SMD -3.389, 95% CI -11.601-4.824; p: 0.419), however, had higher side effect (OR 0.8, p: 0.430, 95% CI 0.389-1.495). Conclusion : PE efficacy is generally lower than IVIG, as indicated by disability scores/motor ability scores in various studies, as well as the duration of hospitalization. The safety of therapy is assessed by the side effects that appear and appear-more-often in IVIG therapy rather than PE.
Acute Hypokalemia Related with Thyrotoxicosis Periodic Paralysis: A Case Report Kadek Reisya Sita Damayanti; Rizaldy Taslim Pinzon
Acta Neurologica Indonesia Vol. 2 No. 02 (2024): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v2i02.26

Abstract

Introduction : Hypokalemia paralysis is a rare condition. Thyrotoxic periodic paralysis (TPP) is a condition of hyperthyroidism characterized with acute muscle weakness and hypokalemia. TPP is commonly found in young Asian male. TPP is an uncommon clinical entity and might be a life threatening complication of thyrotoxicosis. We report a rare case of TPP with ECG abnormality related with severe hypokalemia. Case Report : A-21-year old Javanese male was presented to emergency department with acute onset of lower bilateral extremities weakness with proximal muscle predominant. Weakness progressed to his bilateral upper limb. Patient denied any significant trauma, vomiting, diarrhea, chest pain. Patient was fully conscious. Neurological examination revealed four limb weakness (lower limb muscle strength 2 from 5 scale MRC), diminished deep tendon reflexes, and intact sensory. Laboratory were remarkable for severe hypokalemia of 1.86 mEq/L. Further tests showed low TSH (0.022 mU/L), increased FT4 (23,68 mmol/L). ECG test showed abnormality related with hypokalemia. Thyroid ultrasound revealed multiple thyroid swelling, mass, and calcification. Patient was admitted to ICU and administered with 25mEq Potassium IV. Hypokalemia resolved after 3 days (Serum Potassium 3.76 mEq/L), followed by normal ECG feature without any AV block. He was discharged without any neurological abnormaliy. Conclusion : We report a rare case of acute onset paralysis and markedly low potassium level and high free T4 in previously health Asian male. This case highlights the paralysis related with hyperthyroidism that resolved completely following potassium replacement. Keywords: hypokalemia; paralysis; hyperthyroid; thyrotoxicosis periodic paralysis
Severe Limb Weakness, Bradycardia, and AV Block in Periodic Paralysis Hypokalemia Irfan Nugraha, Dyandika
Acta Neurologica Indonesia Vol. 2 No. 02 (2024): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v2i02.27

Abstract

Introduction : The Periodic Paralysis is an uncommon group of disorders that can cause of sudden extremity weakness. The Hypokalaemia also may present with cardiovascular and neuromuscular abnormalities. Hypokalaemia can lead to clinically significant life-threatening cardiac rhythm abnormality. We present a case of a 32-year-old Javanese with sudden onset paralysis of his extremities. Laboratory evaluation revealed a significant low potassium level. The ECG showed significant bradycardia and AV block. The patient weakness improved gradually after repletion of the low potassium. The ECG also improved to normal sinus rhythm. The patient was discharged without any neurologic deficits. Case Report : A 32 year-old Javanese male presented to the emergency room with sudden four extremity weakness. The patient complain begin when awoke at early morning, and unable to move his upper or lower extremities. The weakness was bilateral and predominantly involved both the proximal muscles of the shoulders and hips as well as the distal extremities. Discussion : We report a case of sudden onset bilateral limbs flaccid weakness. The final diagnosis was periodic paralysis hypokalaemia. Treatment of periodic paralysis hypokalaemia consists of slow and careful correction of low potassium level. The very rapid correction exposes the risk of hyperkalaemia. Close monitoring by neurological examination and repeat examination potassium level is essential. Conclusion : We report a case of sudden onset paralysis and significant cardiac abnormality related with very low potassium level. The paralysis and ECG abnormality resolved completely following potassium replacement. Keywords: Hypokalemia, Periodic Paralysis, AV block, weakness
Balancing Act: Exploring the Complexities of Drug Restriction Policies Ulwanda, Ramadhanti Salma; Nagpal, Chand Dhiraj; Delarosa, Dinda Olinda; Pradiptaloka, Ediva; Ririhena, Fiorentina Cemerlang; Siniwali, Ida Mas Ayu; Rahmadi, Ikhlas; Jeremia, Ivan; Saputri, Liana Alviah; Agustina, Lisa; Alsakina, Nashiha; Marwadhani, Sarah Shafa; Ni'am, Syauqi Faidhun; Pangeran, David
Acta Neurologica Indonesia Vol. 2 No. 02 (2024): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v2i02.28

Abstract

Second Order Horner Syndrome Concurrent with Brachial Plexus Injury Following Thyroid Radiofrequency Ablation: A Case Report Wijaya, Thedi Darma; Saputri, Kevin Mulya; Purwanto, Denni Joko
Acta Neurologica Indonesia Vol. 2 No. 02 (2024): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v2i02.29

Abstract

Introduction: Radiofrequency ablation (RFA) is a non-invasive, yet effective treatment of thyroid nodule. Complications following procedure is reported below 5%. Here, we report a case of Horner syndrome (HS) concurrent with brachial plexus injury (BPI) following RFA. Case Report: A 20-year old female underwent the left thyroid US-guided RFA. She complained of dropped left eyelid, left arm weakness, numbness and tingling sensation on left index finger following surgery. On neurological examination; there were left-sided reduced pupil size on dim light (4 mm/2mm), eye ptosis (6 mm palpebral fissure height), face hypohydrosis, arm weakness (3444+), reduced physiological reflexes, and C5-6 hypesthesia. There was prominent edema extending from left thyroid to whole trunk of left brachial plexus as shown on cervical MRI. The patient was given a high dose methylprednisolone and mecobalamin injection for five days. There was notable improvement on the following month - increased left eye palpebral fissure to 8 mm, equal pupil on dim light, increased left arm strength (44+55) and physiological reflexes. Nonetheless, allodynia on the left shoulder and upper arm persisted. Discussion: Although RFA theoretically produces less power and damage per unit time, it can cause neurological complications. Heat dissipated to surrounding neural tissue including brachial plexus and sympathetic trunk. This patient developed second order HS and BPI due to edema following injury to surrounding middle cervical sympathetic ganglion and brachial plexus. Apt treatment can prevent persistent neurological deficits. Conclusion: HS and BPI are important neurological complications that should be acknowledged following thyroid RFA.
Acute Ischemic Stroke in Moyamoya Disease: A Case Report Kustila, Ela
Acta Neurologica Indonesia Vol. 2 No. 02 (2024): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v2i02.30

Abstract

Introduction: Moyamoya disease (MMD) is also known as spontaneous occlusion of the circle of Willis, is a chronic, occlusive cerebrovascular disease with an unknown etiology.1 It is characterized by progressive stenosis or occlusions of the intracranial internal carotid artery (IAC) and or the proximal portion of the anterior cerebral artery (ACA) and middle cerebri artery (MCA).1,2 This steno-occlusive pattern is associated with a compensatory development of a collateral network of vessels at the base of the brain, appearing as a “puff of smoke” on conventional angiography ( “moyamoya” in Japanese).1,2 The clinical presentations of MMD include transient ischemic attacks, ischemic strokes, hemorrhagic strokes, seizure, headache, and cognitive impairment.1,2,3 Case Report: This case study presents a 48-year-old male with symptoms hemiparesis sinistra. Brain CT scan result was subacute infarct at right anterior cerebri artery territory. Digital Substract Angiography (DSA) result was occlusion in the right media cerebri artery (MCA) and right anterior cerebri artery (ACA), severe stenosis right verterbral artery until basilar artery, moyamoya vessels at anterior and posterior circulation.

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