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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 37 Documents
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Marital Status As A Predictor of Amnestic Mild Cognitive Impairment in Indonesia Fani Agusta Chandra; Octavianus Darmawan
Acta Neurologica Indonesia Vol. 2 No. 01 (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.v2i01.22

Abstract

Introduction: Several modifiable risk factors have been identified as the predictors of amnestic mild cognitive impairment (aMCI). However, research focusing on factors beyond biological is limited. Marital status is a psychosocial factor with recognized impact on health that needs further exploration. Objective: This study aimed to evaluate the association between marital status and aMCI amongst older Indonesian population. Material and methods: This was a cross-sectional study of Indonesian Family Life Survey-5. The participants (≥60 years old), excluding individuals with functional dependency, were subdivided into two based on word list recall (WLR) score (cut-off<6.5). Sociodemographic, psychological factors, physical activity, and body mass index were included as predictors. Bivariate and multivariate analyses were conducted. Result: A total of 4287 participants were included. Significant associations were observed between low WLR score and older age, low education, low socioeconomic status, rural residential area, being unmarried, life dissatisfaction, no social engagement, negative affect, and obesity. Multivariate analysis revealed being unmarried was significantly associated with aMCI (AOR 2.38, 95% CI 1.014–5.589, p=0.046), along with older age, low education, low socioeconomic status, and obesity. Discussion: Being unmarried (never married, divorced, or widowed) is a significant predictor of aMCI amongst Indonesian older people. This finding can be explained by the marital resource model and the stress model. Conclusion: This nationwide study is one of the first to explore marital status as a potential yet underexplored factor of aMCI in Indonesia. Being unmarried is associated with an increased risk of aMCI, prompting different approaches in this population.
Quantitative EEG Findings in Post-Stroke Epilepsy Patients Yetty Ramli
Acta Neurologica Indonesia Vol. 2 No. 01 (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.v2i01.23

Abstract

Post-stroke epilepsy presents a significant clinical challenge, often accompanied by cognitive impairments. The qEEG analysis in this case reveals notable abnormalities, including increased delta waves and decreased high-frequency activity, localized to specific brain regions. These findings not only strengthen diagnostic assessments but also provide valuable insights into the underlying pathophysiology of post-stroke epilepsy. Moreover, they serve as a basis for selecting personalized therapeutic interventions, such as neurofeedback therapy. By tailoring treatment to the captured brainwave frequencies during recording, non-invasive therapeutic options can be explored as viable alternatives for patients. Integrating qEEG findings into clinical practice enhances our understanding of post-stroke epilepsy's complex nature and guides optimal patient care and management strategies.
The Effectiveness of Plasmapheresis Compared to Intravenous Immunoglobulin in Guillain-Barre Syndrome Patients Alyssa Putri Mustika; Manfaluthy Hakim; Waode Satriana Sari; Fitri Octaviana; Astri Budikayanti; Ahmad Yanuar Safri; Winnugroho Wiratman; Luh Ari Indrawati; Nurul Fadli; Adrian Ridski Harsono; Irma Savitri
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.
Depression Level Among Neurology Resident Doctors in the Faculty of Medicine, Universitas Indonesia Vina Dyah Perwitasari; Rakhmad Hidayat
Acta Neurologica Indonesia Vol. 2 No. 01 (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.v2i01.25

Abstract

Introduction: A resident doctor is a doctor who has graduated from medical school, has earned the title of "doctor" and is currently undergoing a specific specialization postgraduate program. Resident doctors are at high risk of experiencing stress and depression. Depression greatly affects the quality of medical services provided by residents. Objective: This study aimed to determine the prevalence of depression, its relationship with various sociodemographic factors and several environmental factors, and its relation to the residency level of resident doctors in the Neurology Study Program, Faculty of Medicine, Universitas Indonesia. Material and Methods: This research was an analytic observational study with a cross-sectional design. All neurology resident doctors of Universitas Indonesia had filling out a questionnaire containing sociodemographic data and the Beck Depression Inventory-II (BDI-II) via Google Form platform. Then, the data were analyzed using chi-square and regression analysis. Result: In this study, 53 (66.2%) participants were females and 16 (33.8%) were males. Sixty-five participants were analyzed with 4 participants excluded. The overall prevalence of depression was 18.2%, with mild depression at 9.2% and moderate depression at 9.2%. Depression was more common in females than males (10.8% vs 7.7%). The residency level and supervisor support have a significant association with the incidence of depression. Conclusion: Our study found that 18.4% of neurology resident doctors had depression. Residency level and senior/supervisor support were significantly associated with depression among resident doctors.
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 Dyandika Irfan Nugraha
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 Ramadhanti Salma Ulwanda; Chand Dhiraj Nagpal; Dinda Olinda Delarosa; Ediva Pradiptaloka; Fiorentina Cemerlang Ririhena; Ida Mas Ayu Siniwali; Ikhlas Rahmadi; Ivan Jeremia; Liana Alviah Saputri; Lisa Agustina; Nashiha Alsakina; Sarah Shafa Marwadhani; Syauqi Faidhun Ni'am; David Pangeran
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 Thedi Darma Wijaya; Kevin Mulya Saputri; Denni Joko Purwanto
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 Ela Kustila
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.
Transcranial Pulse Stimulation as a New Navigated Focal Brain Therapy for Vascular Cognitive Impairment: Case Report Andrie Gunawan; Amanda Tiksnadi; Dyah Tunjungsari; Christine Kathy Putri Sari
Acta Neurologica Indonesia Vol. 2 No. 03 (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.v2i03.33

Abstract

Introduction: To evaluate the cognitive function of vascular cognitive impairment (VCI) after transcranial pulse stimulation (TPS) sessions Case Report: TPS is a non-invasive brain stimulation method. Stimulation was administered using NEUROLITH TPS generator (Storz Medical AG) with 3 Hz ultrashort pulses at 0.25 mJ mm-2 energy density over 12 sessions (6000 pulses per session), three times/week. Target areas included the bilateral DLPFC (1600 pulses per hemisphere), parietal regions (P3, P4) (800 pulses per hemisphere), and precuneus (PCu) (1200 pulses). Cognitive function tests were conducted before the first and after the last TPS session, including MMSE, MoCa-Ina, 15 Boston Naming Test Patient, Digit Span, CERAD (Visuoconstruction, Delayed Memory, Recognition, Verbal Fluency), and Trail Making Test A & B. Discussion: Case 1 was a 48-year-old man with VCI and dysphasia post-stroke infarct (10 months prior), affecting the left caudate nucleus, left lentiform nucleus, and left internal capsule. The patient presented memory and executive function issues but preserved recognition. Case 2 was a 62-year-old man with VCI and anomic aphasia, following a cerebral infarction 5 months prior affected the left putamen, corona radiata, internal capsule, and globus pallidus. After 12 sessions, Case 1 showed amplification in working memory but had executive function challenges. Case 2 demonstrated improvement in immediate memory, recognition, and visuoconstruction, but had lingering issues with delayed verbal, visual memory, and executive function. Conclusion: TPS stimulation of areas for cognitive function appears to enhance memory, recognition, and other cognitive function. TPS may be a novel add‐on therapy for VCI post-stroke patients.

Page 2 of 4 | Total Record : 37

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