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Yang Yang Endro Arjuna
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Universitas Pelita Harapan, Lippo Karawaci, Tangerang, Indonesia, 15811.
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Lumina: Indonesian Journal of Neurology
Published by Universitas Pelita Harapan
ISSN : 31095658     EISSN : 3109564X     DOI : https://doi.org/10.19166
Core Subject :
Focus and Scope Lumina: Indonesian Journal of Neurology is an open-access, peer-reviewed journal dedicated to advancing the field of neurological sciences, with a focus on both basic neuroscience and clinical neurology. The journal publishes original research, reviews, and intriguing case reports. It also welcomes brief communications that highlight recent advancements in diagnostic techniques, treatments, or other relevant neurological health issues. Additionally, letters and commentaries on previously published articles are encouraged. Topics for publication include, but are not limited to: Neuroepidemiology Neurovascular Neurophysiology Epilepsy Sleep disorders Neurobehavior Neuroimmunology Neurodegenerative diseases Neurootology Neuroophthalmology Neuropediatrics Neurointervention Neuroradiology Neurorestoration Movement disorders Pain management and interventions Neuroendocrinology Neurosurgery Neuropathology Neuroinfection Neuroanesthesiology Neurooncology Neuropharmacology Neuroanatomy
Arjuna Subject : -
Articles 30 Documents
 1   2   3 
Contributions of Nursing Professionals and Primary Care Physicians in Interdisciplinary Oncology Teams for Cancer Pain Management: An Analytical Review Henry Riyanto Sofyan; Anne Dina Soebroto; Eunike Novrilia; Ratu Novia Putri Aulia; Daniel Budi Utomo; Liliana Mangkuwerdojo; Erico Mulfiardi; Radja Buntal Sotarduga Simanjuntak; Made Agus Mahendra Inggas
Lumina : Indonesian Journal of Neurology Vol. 2 No. 1 (2026): April: Lumina: Indonesian Journal of Neurology
Publisher : Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/lijn.v2i1.10963

Abstract

Introduction: Cancer-related pain remains inadequately managed in a substantial proportion of oncology patients, despite established clinical protocols. Current systematic evidence indicates that up to 55% of patients experience undertreated pain.35 Interdisciplinary oncology teams — comprising nursing professionals and primary care physicians (PCPs) — are a critical organizational strategy for improving cancer pain management across the care continuum. Methods: A systematic narrative synthesis was conducted using 30 peer-reviewed sources identified through structured searches of the PubMed, CINAHL, Scopus, and Cochrane databases. Inclusion criteria encompassed studies, reviews, and guidelines published from 2002 to 2025 that addressed professional roles, team structure, barriers, and clinical outcomes in cancer pain management. Results: Nursing professionals contribute substantially to pain assessment and management through validated instruments, pharmacological and non-pharmacological interventions, patient self-management education, and interdisciplinary advocacy. PCPs facilitate care coordination, ensure analgesic prescribing continuity, and manage the primary–specialty interface. Effective interdisciplinary teams improve patient outcomes through structured communication, clear roles, and integrated care pathways. Persistent barriers include care fragmentation, professional role ambiguity, competency gaps, and regulatory constraints on opioid prescribing. Conclusions: Although current evidence supports the effectiveness of interdisciplinary approaches to improving cancer pain outcomes, significant gaps remain in comparative effectiveness data, implementation science, and health equity research. Enhanced clinical training, organizational investment, and policy reform are necessary to optimize collaborative cancer pain management across diverse healthcare settings. Keywords: Cancer Pain, Interdisciplinary Teams, Nursing Professionals, Primary Care Physicians, Collaborative Care, Palliative Care, Pain Mechanisms
Brainstem Stroke From Rare Case of Foville Syndrome Kevin Aldenio Hatma Krista; Rizaldy Taslim Pinzon; Kehat Dowie Setiabudi Arrung; John Kelvin Bastian Dowansiba
Lumina : Indonesian Journal of Neurology Vol. 2 No. 1 (2026): April: Lumina: Indonesian Journal of Neurology
Publisher : Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/lijn.v2i1.10998

Abstract

Introduction: Foville syndrome is a rare neurological syndrome resulting from infarction in the perforating branches of the basilar artery, involving the nuclei of cranial nerves VI and VII and the corticospinal tract. It is clinically characterized by ipsilateral horizontal gaze palsy, ipsilateral peripheral facial paralysis, and contralateral hemiparesis. Its rarity often poses diagnostic challenges in clinical practice. Case Presentation: A 54-year-old woman presented with sudden diplopia and right-sided weakness for 16 hours. She had a history of controlled hypertension and diabetes mellitus. Neurological examination revealed left horizontal gaze palsy, left peripheral facial weakness, and right hemiparesis (muscle strength 2/5). Brain CT showed pontine infarction with severe basilar artery stenosis. The patient was treated with dual antiplatelet therapy, high-intensity statin, and supportive therapy including eye patching and physiotherapy. She was discharged after 8 days with moderate disability (mRS 3) and showed improvement to mild disability at 3-month follow-up. Discussion: Foville syndrome results from lesions in the pontine tegmentum involving the abducens nucleus, facial nerve fibers, and corticospinal tract. It is commonly caused by ischemic infarction due to atherosclerotic basilar artery disease. Clinical findings in this case align with the classic triad. Management depends on onset time; thrombolysis was not indicated due to delayed presentation. Dual antiplatelet therapy and risk factor control remain the mainstay treatment. Conclusions: We report a rare case of Foville syndrome that arises as a result of an infarction stroke affecting the pons. Keywords: Basilar Artery Stenosis, Brainstem Stroke, Foville Syndrome, Pontine Infarction
The Association Between Body Mass Index and Carpal Tunnel Syndrome Among Medical Students of Universitas Pelita Harapan: A Cross-Sectional Study Riona Sutanto; Vivien Puspitasari; Astra Dea Simanungkalit; Pricilla Yani Gunawan
Lumina : Indonesian Journal of Neurology Vol. 2 No. 1 (2026): April: Lumina: Indonesian Journal of Neurology
Publisher : Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/lijn.v2i1.11012

Abstract

Introduction: Carpal Tunnel Syndrome (CTS) is one of the most common entrapment neuropathies, though its exact cause remains unclear.  Obesity has been identified as a potential risk factor, but previous studies have reported inconsistent findings.  This study aimed to analyze the association between Body Mass Index (BMI) and CTS among pre-clinical medical students at Universitas Pelita Harapan. Methods: This cross-sectional study utilized the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) to assess symptom severity and functional status.  Body weight and height were self-reported via questionnaire to calculate BMI. Bivariate analyses are used to examine the association statistically, followed by stratified analyses to assess potential confounding factors. Results: A total of 201 participants met the inclusion and exclusion criteria for this study. Among them, 7.5% of the subjects presented with symptoms of CTS, and 5.0% experienced functional impairment. The association between BMI and CTS based on the severity of symptoms and functional status impairment was found to be significant (p = 0.004 and 0.049, respectively). Conclusion: Higher BMI was significantly associated with an increased likelihood of CTS symptoms and functional impairment. Gender and a history of diabetes mellitus were identified as potential confounding factors. Keywords: Carpal Tunnel Syndrome, Body Mass Index, Obesity
Diagnostic Accuracy of Blood-Based Biomarkers for Early Detection of Alzheimer’s Disease: A Systematic Review Cindy Permata Sari; Rocksy Fransiska V. Situmeang; Tandry Meriyanti
Lumina : Indonesian Journal of Neurology Vol. 2 No. 1 (2026): April: Lumina: Indonesian Journal of Neurology
Publisher : Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/lijn.v2i1.11078

Abstract

Introduction: Alzheimer’s disease (AD) continues to impose a significant global health burden, while early detection remains limited by the reliance on invasive and costly diagnostic methods such as PET imaging and cerebrospinal fluid (CSF) analysis. Blood-based biomarkers have gained attention as a more accessible alternative. This study aims to assess the diagnostic performance of plasma p-tau217, p-tau181, and Aβ42/40 in detecting early-stage AD. Methods: A systematic review was conducted using predefined inclusion criteria. Studies were selected if they evaluated plasma biomarkers against established reference standards (CSF biomarkers, PET imaging, or neuropathology), reported diagnostic accuracy measures, and included individuals with early cognitive impairment. Extracted data covered study characteristics, assay methods, population profiles, cutoff approaches, and longitudinal outcomes. Results: Seventeen studies involving more than 7,000 participants were included. Plasma p-tau217 consistently demonstrated the highest diagnostic accuracy across studies, with AUC values generally exceeding 0.90. Plasma p-tau181 also showed good diagnostic performance but with greater variability, particularly in early disease stages. In contrast, Aβ42/40 alone exhibited lower and less consistent accuracy, although its performance improved when combined with phosphorylated tau biomarkers. Variability in assay platforms, population characteristics, and cutoff values contributed to heterogeneity across studies. Conclusions: Plasma p-tau217 shows strong and consistent diagnostic performance across different populations and settings, approaching that of CSF and PET biomarkers. It holds considerable potential as a practical and minimally invasive tool for early AD detection, although further standardization is still needed. Keywords: Alzheimer’s Disease, P-tau217, Blood-based Biomarkers, Early Detection, Diagnostic Accuracy
Neurotherapies for Long COVID: Rewiring Fatigue, Mental Health, and Quality of Life Through a Systematic Review and Network Meta-Analysis Maria Sri Crishnatalia Wirodihardjo; Ardina Lukito Sampurno; Fauzan Ahmad Arkanokahfi Indrawan; Teresa Wulan Karenina; Tiffney Tyara Setyoko
Lumina : Indonesian Journal of Neurology Vol. 2 No. 2 (2026): August: Lumina Indonesian Journal of Neurology
Publisher : Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/lijn.v2i2.10397

Abstract

Introduction: Long COVID affects nearly 36% of post-infected individuals worldwide, many of whom experience persistent neurological symptoms such as fatigue, cognitive impairment, and mood disorders. Despite growing recognition of this condition, the most effective nonpharmacological strategies remain unclear. This study aimed to determine optimal neurotherapy to improve fatigue, mental health, and quality of life (QoL) in Long COVID patients. Methods: A systematic review of a network meta-analysis was conducted following the PRISMA NMA guidelines. Literature searches were made using Pubmed, EBSCOhost, Wiley, and Scopus up to May 2025. Randomized controlled trials (RCT) were included with patients suffering from long COVID and treated with non-pharmacological therapy. Standard mean differences (SMD) were calculated using a frequentist approach, and treatments were ranked using the Surface under the Cumulative Ranking Curve (SUCRA). Risk of bias and certainty of evidence were assessed using the Cochrane RoB-2 and GRADE framework. Results: Fourteen RCTs including 1,309 participants were included in the analysis. Affective and cognitive integrated therapy achieved the greatest result of decreased fatigue severity (SMD = –5.01, 95% CI –6.38 to –3.65). Multimodal therapies combining aerobic training, strength conditioning, respiratory neuroplasticity training and telerehabilitation improved QoL (SMD = 7.55, 95% CI 5.14 to 9.95). The mental health data remained insignificant due to the data being heterogeneous and publication bias. Conclusions: Affective and Cognitive Integration and multimodal rehabilitation show potential for providing relief for fatigue and enhancing QoL in Long COVID patients. However, further standardized and longitudinal studies are needed to understand their effects on mental health. Keywords: Long COVID, Neurorehabilitation,  Fatigue,  Quality of Life, Network Meta-Analysis, Non-pharmacological Therapy
Sleep Duration and Pain Intensity in Medical Students with Tension-Type Headache: A Cross-Sectional Study Annisa Permata Eqlevina; Tasya Meidy Pradhana; Yusak Mangara Tua Siahaan
Lumina : Indonesian Journal of Neurology Vol. 2 No. 2 (2026): August: Lumina Indonesian Journal of Neurology
Publisher : Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/lijn.v2i2.10540

Abstract

Introduction: Tension-type headache (TTH) is the most common primary headache disorder and frequently affects medical students. Sleep disturbances, particularly insufficient sleep duration, have been implicated as risk factors that may worsen headache intensity. This study aimed to investigate the relationship between sleep duration and pain intensity among medical students with TTH at Universitas Pelita Harapan. Methods: A cross-sectional analytic study was conducted from February to May 2025. A total of 186 students were screened, and 84 met the inclusion criteria. TTH was assessed using a validated 13-item questionnaire, pain intensity was measured with the Numeric Rating Scale (NRS), and sleep duration was self-reported and categorized as sufficient (≥7 hours) or insufficient (<7 hours). Stress levels were controlled using the 10-item Perceived Stress Scale (PSS-10). Data were analyzed with the Pearson Chi-Square test, and odds ratios (OR) with 95% confidence intervals (CI) were calculated. Results: Most participants were female (70.2%), and the majority reported insufficient sleep (65.5%). Moderate and severe TTH pain was reported by 39.3% and 39.3% of respondents, respectively. A significant association was observed between insufficient sleep and higher pain severity (p < 0.001). Students with insufficient sleep were 32.6 times more likely to report moderate–severe pain compared to those with sufficient sleep (OR = 32.615, 95% CI: 6.650–159.973). Conclusion: Short sleep duration is strongly associated with increased pain intensity in medical students with TTH. Keywords: Tension-Type Headache, Sleep Duration, Pain Intensity, Medical Students, Numeric Rating Scale
Neuropathic Pain in Syringomyelia: A Case Report and Comprehensive Review of Clinical Management Rizaldy Taslim Pinzon; Bernadeta Amaya; Stefanus Erdana Putra
Lumina : Indonesian Journal of Neurology Vol. 2 No. 2 (2026): August: Lumina Indonesian Journal of Neurology
Publisher : Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/lijn.v2i2.11011

Abstract

Introduction: Syringomyelia is an uncommon chronic spinal cord disorder characterized by the formation of a fluid-filled cavity (syrinx) within the neural parenchyma. This condition leads to progressive neurological impairment and severe neuropathic pain. This case report discusses the clinical presentation and comprehensive management of a patient with this condition. Case Presentation: A 39-year-old female presented with a two-year history of severe burning pain, sensory loss in a "cape-like" distribution, and progressive weakness of the hands. Magnetic Resonance Imaging (MRI) of the cervical and thoracic spine demonstrated a prominent, hyperintense cervicothoracic syrinx (C2–T2) secondary to adult Chiari malformation type 1 (CM1). Discussion: Initial gabapentin and amitriptyline yielded only partial pain control. Due to progressive lower motor neuron decline and refractory neuropathic pain, surgical intervention was indicated. Although foramen magnum decompression (FMD) remains the primary standard of care for restoring craniocervical CSF flow, a targeted syringo-subarachnoid shunting (SSS) procedure at the T1 level was used as a secondary rescue intervention to achieve rapid mechanical decompression of the massive, tense syrinx. Postoperatively, the patient demonstrated significant neurological improvement, with the Numeric Pain Rating Scale (NPRS) score decreasing from 7–8 to 3–4, alongside gradual motor recovery. Conclusions: Neuropathic pain in syringomyelia is complex and requires a multimodal, multidisciplinary approach. While FMD is the primary gold standard for Chiari I-associated syringomyelia, SSS represents a viable secondary option for rapid mechanical decompression in cases presenting with giant, highly symptomatic syrinxes and progressive motor decline, despite carrying higher long-term revision and complication risks. Keywords: Chiari Malformation, Chronic Pain, Neuropathic Pain, Syringomyelia, Syringo-Subarachnoid Shunt
Multiple Sclerosis with Limited Treatment Options: A Case Report on Azathioprine as an Alternative Therapy Nicholas Ciarico; Kennytha Yoesdyanto; Iglesias Owen
Lumina : Indonesian Journal of Neurology Vol. 2 No. 2 (2026): August: Lumina Indonesian Journal of Neurology
Publisher : Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/lijn.v2i2.11134

Abstract

Introduction: Multiple sclerosis (MS) is a chronic immune-mediated disease affecting the central nervous system, characterized by demyelination and progressive disability. Estimated prevalence in Indonesia is approximately 0.01 per 100,000 population. Treatment includes managing acute relapses with corticosteroids and DMT to prevent relapses and further disability. Immunosuppressants such as azathioprine are often used in Indonesia as a more accessible and affordable alternative to standard DMTs. Case Presentation: A 30-year-old woman presented to neurology outpatient with history of progressive bilateral lower limb weakness since 2019, accompanied by urinary dysfunction and numbness below abdominal region. Neurological examination revealed paraparesis of lower limbs, hyperreflexia, positive bilateral Babinski signs, hypoesthesia below T10. Brain MRI demonstrated demyelinating lesions in the corpus callosum, bilateral periventricular white matter, and subcortical frontal and parietal lobes, forming a Dawson’s finger pattern. Spinal MRI revealed a demyelinating lesion at the T11 level. Cerebrospinal fluid (CSF) analysis showed type 2 oligoclonal bands. The patient was diagnosed with multiple sclerosis and treated with intravenous methylprednisolone and azathioprine as maintenance. Discussion: The clinical presentation, characteristic MRI findings, and positive oligoclonal bands supported the diagnosis of multiple sclerosis. Although azathioprine is not considered a first-line DMT, it remains a practical treatment option where access to approved therapies is limited. Conclusions: This case highlights the importance of integrating clinical, radiological, and CSF findings in diagnosing multiple sclerosis. Treatment should be individualized according to the patient's clinical condition and available healthcare resources, while improving access to evidence-based DMTs remains an important goal. Keywords: Multiple Sclerosis, Azathioprine, Demyelination, Oligoclonal Bands, Dawson’s Fingers
Early Detection of Ossification of the Posterior Longitudinal Ligament (OPLL) in Patients with Degenerative Cervical Myelopathy (DCM) Hans Christian Uranus; Dorothea Fortuna Meita Caturwulan; Derry Arkan Prabowo; Filjordan Andrisoni Imanuel Lulupoy; Josua Kristiano Hilmanto
Lumina : Indonesian Journal of Neurology Vol. 2 No. 2 (2026): August: Lumina Indonesian Journal of Neurology
Publisher : Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/lijn.v2i2.11443

Abstract

Introduction: Degenerative changes in the cervical spine leads to Degenerative Cervical Myelopathy (DCM). Ossification of posterior longitudinal ligament (OPLL) is a common cause of DCM in Asian populations and causes severe neurological deficits, which significantly impairs quality of life. Case Presentation: A 49-year-old Sunda woman presented with progressive numbness and tingling sensation followed by progressive weakness in the lower extremities. Progressive weakness then developed in the upper extremities. Physical examination revealed tetraparesis and reflexes increased in all extremities. Sensory examination revealed hypoesthesia in the right T5-T12 dermatome, and bilateral L1-S2 dermatome. She was assessed as grade 3 Nurick classification of myelopathy and has a Modified Japanese Orthopaedic Association Score (mJOA) Score of 15. Non-contrast Cervical magnetic resonance imaging (MRI) revealed continuous OPLL type at C3-C5 level. She received high dose intravenous methylprednisolone and was referred to another hospital for surgery. Discussion: OPLL has not been documented extensively in Indonesia. Early detection of DCM can be done with a mJOA score of ≤16. Conservative treatment is recommended for minimally symptomatic or high-risk surgery patients. Surgical intervention has shown significant improvement in clinical outcome, although it is not beneficial in absent or minimal myelopathy (Nurick grade 1 or 2). Conclusions: OPLL is a common cause of DCM in Asian populations. Early detection using mJOA is paramount to achieve better recovery. Conservative treatment is done for mild DCM while surgical intervention is done in moderate to severe DCM. Keywords: Conservative Treatment, Degenerative Cervical Myelopathy (DCM), Modified Japanese Orthopaedic Association Score (mJOA), Nurick Classification of Myelopathy, Ossification of Posterior Longitudinal Ligament (OPLL), Surgical Intervention
The Role of Olfactory Testing in Detecting Prodromal Phase Parkinson’s Disease: A Literature Review Anastasia Ezragitha Soligaon Pasaribu; Melya Arianti Umbul
Lumina : Indonesian Journal of Neurology Vol. 2 No. 2 (2026): August: Lumina Indonesian Journal of Neurology
Publisher : Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/lijn.v2i2.11522

Abstract

Introduction: Parkinson's disease (PD) is a progressive neurodegenerative disorder traditionally diagnosed based on classic motor symptoms. However, these motor manifestations appear only after a substantial loss of dopaminergic neurons in the substantia nigra. Detecting PD during its prodromal phase offers a crucial therapeutic window to potentially delay disease progression. Hyposmia is one of the earliest and most prevalent non-motor markers, appearing up to a decade before motor onset. Methods: A comprehensive literature search was conducted across electronic databases, including PubMed, Cochrane Library, and Google Scholar. The inclusion criteria were restricted to original research articles published within the last five years (2021–2026) in English or Indonesian. Data regarding olfactory testing accuracy and cultural adaptation were synthesized. Results: Standardized olfactory assessment tools, such as the University of Pennsylvania Smell Identification Test (UPSIT), Sniffin' Sticks, and the Brief Smell Identification Test (B-SIT), demonstrate high sensitivity (79%) and specificity (81%) in distinguishing PD from diagnostic mimics. Nevertheless, international screening tools frequently suffer from cross-cultural bias due to unfamiliarity with Western odorants. Emerging evidence indicates that adapting these instruments using locally familiar Asian and Indonesian olfactory stimuli (e.g., coffee, jasmine, aromatic ginger, and cajuput oil) significantly optimizes diagnostic accuracy. Conclusions: Brief olfactory assessments, particularly those tailored to regional and cultural settings, serve as highly effective, cost-efficient, and non-invasive screening instruments for prodromal PD detection within routine neurogeriatric clinical practice. Keywords: Parkinson's Disease, Olfactory Testing, Hyposmia, Prodromal Phase, Cross-Cultural Adaptation

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