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Ramadhanti Salma Ulwanda
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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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Popeye Sign From Rupture Bisceps Brachii : A Case Report La Luna Dinada Tesalonika
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.v2i03.34

Abstract

Introduction : Biceps tendon rupture without trauma is rare. Most cases occur at the junction between the tendon and the labrum or at the bony attachment site. Advanced age, smoking, and corticosteroid use are common risk factors for tendon degeneration and tendinopathy. Case Report : A 68-year-old male from Java came in with abrupt discomfort and swelling in his right arm. After examining him and using ultrasound, we found that he had a ruptured biceps tendon. To treat this, we chose a conservative approach with physical therapy and non-steroidal anti-inflammatory drugs (NSAIDs). Initially, we applied ice, supportive bandages, and once the risk of bleeding decreased, we gave him NSAIDs and advised rest. After four weeks of treatment, the patient's condition improved. Conclusion : A case of total atraumatic rupture of the proximal biceps tendon is presented in this report. The significance of the "Popeye sign" as a pathognomonic indicator is emphasized. The absence of the tendon within the bicipital groove was confirmed through a shoulder ultrasound, thus validating the diagnosis
A Familial Hypokalemic Periodic Paralysis : A Case Report Rizaldy Taslim Pinzon; Yutta Larasati
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.v2i03.36

Abstract

Hypokalemic periodic paralysis is characterized by recurrent attacks of skeletal muscle weakness with related hypokalaemia which is a rare genetic disorder. There might be a limited weakness for some groups of muscle, or it might appear as severe muscle paralysis. The muscle cells increase the uptake of potassium, hence the decreasing of potassium’s mechanism. The case of a clinically diagnosis familial hypokalaemia periodic paralysis in a 9-year-old boy that we report is established in this proband that settle the consensus diagnosis criteria for primary hypokalaemia periodic paralysis according to previous review that’s been published. Key words: paralysis-hypokalemia-periodic-familial.
The Reliability Test Of Indonesian Wearing-Off Questionnaire-19 (WOQ-19) Jovan Aji; Pinzon Rizaldy Taslim
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.v2i03.37

Abstract

Introduction : Wearing-off is a common complication that happen on Parkinson’s patient with dopaminergic therapy. Identifying when wearing-off occurs is important because it can help medication and increase patient’s quality of life. One of the instruments that can be used to help identifying wearing-off phenomenon is the Wearing-off Questionnaire-19 (WOQ-19). However, there is no translated version of Indonesian WOQ-19 that has been tested for it’s reliability. Objective : To measure the reliability of Indonesian Wearing-off Questionnaire-19 as an instrument to identify wearing-off phenomenon on Parkinson patient. Material and methods : The original version of Wearing-off Questionnaire-19 translated to Indonesian language with forward-backward translation procedure and approved by the original author. This is an observational; cross sectional study carried out at Yogyakarta Bethesda Hospital. Thirty Parkinson’s patients from October to December 2023 in medical records and the result of WOQ-19 Indonesian version. The reliability of the questionnaire were measured by Cronbach α and intraclass correlation coefficient. Result and Discussion : Study conducted on 30 Parkinson’s patients with mean age 70.73 ± 8.68 dominated by men 66.6% and mean duration of Parkinson’s disease 5.2 years. The Indonesian WOQ-19 showed good reliability with intraclass correlation coefficient of 0.796 (IC 95%) and good internal consistency with Cronbach alpha of 0.683. Conclusion : Indonesian WOQ-19 is reliable as an instrument that can be used to detect wearing-off phenomenon on Parkinson’s patients.
Neuropsychiatric Manifestation on Anti-NMDAR Encephalitis: A Case Report Tanuwijaya Andrew W
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.v2i03.39

Abstract

Introduction : Anti-NMDA (N-methyl-D-aspartate) receptor encephalitis (Anti-NMDAR Encephalitis) is a rare autoimmune disorder that primarily affects the central nervous system, which is characterized by complex neuropsychiatric disorders and the presence of Immunoglobulin G (IgG) against the NR1 subunit of the NMDA-receptor in the central nervous system. This disease is one of the most commonly diagnosed autoimmune encephalitis. Frequently misdiagnosed, an accurate examination is required. Case Report : A 24-year-old female presented with continuous seizures and psychiatric disorders such as hallucinations and behavioral changes. Physical examination revealed loss of consciousness, fever, positive meningeal sign, and involuntary movement in the mouth and left hand. Immunofluorescence test revealed positive anti-NMDA antibodies, lumbar puncture revealed pleocytosis, head contrast enhanced CT-scan suggests meningoencephalitis, and electroencephalography revealed ictal and interictal epileptiform discharges. The patient is diagnosed with the Anti-NMDAR Encephalitis. Discussion : Anti-NMDAR Encephalitis is a rare autoimmune encephalitis that affects the central nervous system because the body’s immune system mistakenly attacks the NMDA receptor in the brain. The main symptoms consist of a combination of neurologic and psychiatric symptoms. Treatment of this disease could include corticosteroids, Intravenous Immunoglobulin (IVIG), and plasma exchange if necessary, followed by supportive care to treat the symptoms. Conclusion : Anti-NMDAR Encephalitis is a rare form of autoimmune encephalitis that should be included in the differential diagnosis when facing a patient with neuropsychiatric disorder, especially in patients who have never experienced psychiatric symptoms before.
A Comprehensive Approach to Ending Bullying in Indonesia's Medical Residency Programs: A Policy Brief Siti Pujiwati Permata Rima; Annisa Fitri Bumantari; Bayuni Izzat Nabillah; Chandrika Najwa Malufti; Gunawan Adhiguna; Henry Hadianto; Jurika Kakisina; Noryanto Ikhromi; Nur Izzaty Amalia; rezka dwi Fathana; Risa Jaehan; stefanie karina Putri; Yosia Putra Setiawan
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.v2i03.40

Abstract

Bullying is a pervasive issue in medical education and practice, affecting educators, residents, nurses, and students. In Indonesia, it has emerged as a significant concern, particularly within medical residency programs. Often described as a chronic problem, bullying in medicine negatively impacts patient care and is difficult to eradicate. It occurs both in professional settings and through digital platforms like WhatsApp and Telegram. Bullying in medical education takes various forms, including physical and non-physical, and often escapes the attention of faculty, universities, teaching hospitals, and victims' families. These acts, typically carried out by senior students in an organized manner, may be falsely perceived as part of the mentoring process, masking the harmful behavior.1
HEPATIC METASTATIC MENINGIOMA FOLLOWING REPEATED INTRACRANIAL REMOVAL SURGERIES : Hepatic Metastatic Meningioma Audrey Clarissa; Tiara Aninditha; Eka Susanto; Kemal Fariz Kalista; David Tandian; Irma Savitri Madjid; Henry Riyanto Sofyan
Acta Neurologica Indonesia Vol. 3 No. 01 (2025): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v3i01.41

Abstract

Introduction : Meningioma is mostly benign. With appropriate management, it may have a good prognosis. However, it may reoccur and metastasize in <1% of all cases. Studies describing re-occurrences of meningioma and extracranial metastasis, especially to the liver, are limited. Case Report : A 54-year-old female with secondary headache, cognitive impairment, blindness in the left eye, and paresis of the left facial nerve due to recurrent left spheno-orbital meningioma with scalp invasion had undergone four tumor removal surgeries. Previous histopathological findings were atypical meningioma (2017) and transitional meningioma (2023). A suspicion of a new primary tumor arose as an increase in transaminase and multiple liver nodules were observed despite being an asymptomatic patient. Histology and immuno-histochemistry from the intracranial tumor was an atypical meningioma, and cancer in the liver had a similar immunohistochemistry profile as the intracranial tumor, suggesting meningioma metastasis. Discussion : Recurrences were more prevalent in higher histologic grading, which can lead to serial operations, higher complication rates, and morbidities. While the lungs are the most common site for metastasis, hepatic metastasis is thought to be underestimated as patients are often asymptomatic. Factors such as scalp and brain invasion, blood vessel proximity, meningioma recurrences, and subtotal resection increase the risk of metastasis. To date, there are no specific guidelines on metastasis treatment. Conclusion : Meningioma can re-occur and metastasize to distant organs despite its usual benign characteristics. Aggressive tracking should be implemented in females with recurrent meningioma and scalp involvement
RARE CASE OF LEPTOMENINGEAL METASTASES FROM POORLY DIFFERENTIATED PAROTID CARCINOMA : RARE CASE OF LEPTOMENINGEAL METASTASES Tiara Aninditha; Dyah Ayu Puspita Anggarsari; Radius Kusuma; Eka Susanto; Erwin Danil Yulian; Irma Savitri; Henry Riyanto Sofyan
Acta Neurologica Indonesia Vol. 3 No. 01 (2025): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v3i01.43

Abstract

exceedingly rare and challenging to diagnose, requiring confirmation via imaging and cerebrospinal fluid (CSF) cytology. Clinical signs like secondary headache often signal critical intracranial involvement. Case Report: A 27-year-old woman presented with severe headache, dizziness, and vomiting. She had a history of poorly differentiated parotid carcinoma with liver metastases and prior chemotherapy (CAF: cisplatin, doxorubicin, and fluorouracil). Physical exam revealed mild peripheral facial nerve palsy, ataxic gait, and tremor. High-dose dexamethasone and acetaminophen provided headache relief. CT brain imaging showed vasogenic edema with leptomeningeal enhancement in the right cerebellum and a 46% reduction in the parotid lesion. MRI of the nasopharynx identified leptomeningeal enhancement, notably in the right cerebellum, suggesting metastasis, along with fourth ventricle narrowing and ventricular dilation. CSF cytology revealed poorly differentiated malignant cells with pleomorphic nuclei. Craniospinal irradiation was planned. Discussion: Leptomeningeal metastasis is an uncommon parotid carcinoma complication. Secondary headache, diffuse and bilateral, typically affects the C2-C3 dermatome and is accompanied by dizziness. Symptom relief with high-dose dexamethasone was observed. Definitive LM diagnosis combines CSF cytology and MRI leptomeningeal enhancement. As chemotherapy options for LM from parotid carcinoma are limited, craniospinal irradiation is the preferred treatment. Conclusion: Leptomeningeal metastasis from poorly differentiated parotid carcinoma is extremely rare, confirmed by clinical signs, imaging, and CSF analysis. Severe secondary headache is a key indicator, and delayed diagnosis could prove fatal.
Posterior Reversible Encephalopathy Syndrome Secondary to Mild Renal Artery Stenosis induced Hypertension in Child: A Case Report Martelina, Yiska; Ananda Digdoyo; Wikrama, Ketut Wiswa
Acta Neurologica Indonesia Vol. 3 No. 01 (2025): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v3i01.44

Abstract

Introduction: In addition to neurological symptoms such as impaired consciousness that can result in the rare incidence of a comatose state, seizures, and visual impairment, posterior reversible encephalopathy syndrome (PRES) is represented by a various type of non-specific symptoms such as headache, nausea, and vomiting. These clinical features are associated with distinctive imaging findings of vasogenic edema, primarily located in the bilateral posterior or parieto-occipital lobes, which is generally reversible. Case Report: We present here, a young 7-years-old girl, with a medical history of hypertension, sudden loss of consciousness lasting 1 minute, stereotypic seizures lasting 5 to 10 seconds with unknown etiology, had a history of blurred vision for approximately 24 hours after the seizures, multiple projectile vomiting, dizziness and altered mental status for 1 week. The characteristics of vasogenic edema observed in the bilateral parieto-occipital lobe, as seen in CT-scan imaging, along with the reversal of symptoms, contributed to the diagnosis of PRES in our patient. After the hypertension was treated and the symptoms were reversed, the patient was discharged in a stable condition. Conclusion: We report a case is a Posterior Reversible Encephalopathy Syndrome in young patient caused by hypertension and triggered by renal artery stenosis. Hypertension must be treated in patients with neurological symptoms like loss of consciousness, dizziness, and blurred vision. Suspicion of PRES must be considered a special case.
RAMSAY HUNT SYNDROME: A CASE REPORT Gavrila, Priska Gian; Rizaldy Taslim Pinzon
Acta Neurologica Indonesia Vol. 3 No. 01 (2025): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v3i01.47

Abstract

Introduction : Ramsay Hunt Syndrome or Herpes Zoster Oticus, is a rare and severe complication of varicella zoster virus reactivation. The syndrome consists of: the presence of vesicles in the auditory canal, otalgia, and ipsilateral facial paralysis. If this condition was not treated properly, the full recovery chances only occurs in as little at 20% of cases. Early treatment with steroid and antiviral that started within 72 hours will improve the prognosis. We report a rare case of Ramsay Hunt Syndrome that occurs after 20 days of rash eruption. Case Report : We report a case of 56-year-old male that referred because of painful herpetic neuralgia and facial nerve palsy. The patient developed right-sided facial burning pain that followed with the presence of erythematous, vesicular rash erupted at fore head and ear. Exam showed a similar rash along the auricle and the external auditory canal. On day 24, the patient woke up with partial right-sided facial paralysis and he was referred to the neurology clinic. In the neurology clinic, Ramsay Hunt Syndrome was diagnosed. Discussion : We report a rare case of Ramsay Hunt Syndrome. The mechanism involve reactivation of dormant varicella zoster virus. After primary varicella infection, the virus may stay dormant in sensory dorsal root ganglia. The reactivation causes shingles, ipsilateral vesicular eruption that limited with dermatomal distribution. Conclusion : We report a rare case of Ramsay Hunt Syndrome. This was a very rare complications of varicella zoster reactivation. Keywords: Neuralgia1; Facial Palsy2; Ramsay Hunt3 ; Varicella Zoster4
Educating General Practitioners about Medication-overuse Headache: Importance and Call to Action Sofyan, Henry Riyanto; Madjid, Irma Savitri; Faiq, Ahmad Rafi; Indrapriambada, Ery Riady; Humaira, Sarah; Aninditha, Tiara
Acta Neurologica Indonesia Vol. 3 No. 01 (2025): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v3i01.49

Abstract

Medication overuse headache (MOH) is a secondary headache that frequently accompanied chronic primary headaches which poses a great burden in an individual and systemic level. Globally, it is recognized as one of the relevant headaches for primary care. However, in Indonesia, it has not been included in the standard competence for doctors, and therefore has been underrecognized by general practitioners who encountered headache patients in primary care. In this policy brief, we mapped the problems regarding MOH and proposed several action plans, including educating GPs, as the recommendations.

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