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MNJ (Malang Neurology Journal)
Published by Universitas Brawijaya
ISSN : 24076724     EISSN : 24425001     DOI : -
Core Subject : Science,
Neuroscience
Malang Neurology Journal is a peer-reviewed and open access journal that focuses on promoting neurological sciences generated from basic neurosciences and clinical neurology. This journal publishes original articles, reviews, and also interesting case reports. Brief communications containing short features of medicine, latest developments in diagnostic procedures of neurology disease, treatment, or other health issues related to neurology that is important also acceptable. Letters and commentaries of our published articles are welcome.
Arjuna Subject : -
Articles 322 Documents
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HEART RATE VARIABILITY AS A NON-INVASIVE CARDIO-AUTONOMIC BIOMARKER FOR SLEEP DISORDER AND COGNITIVE DECLINE IN EPILEPSY: A LITERATURE REVIEW Pikatan, Orlando; Indrasari Utami, Desak Ketut; Ayu Putri Laksmidewi, Anak Agung; Meidiary, Anak Agung Ayu; Arimbawa, I Komang; Widyantara, I Wayan
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.02.11

Abstract

Background: Epilepsy is a chronic neurological disorder affecting over 50 million people worldwide, often compounded by significant but undertreated comorbidities such as sleep disturbances and cognitive impairment. Heart Rate Variability (HRV), a non-invasive biomarker for the dynamic balance of the autonomic nervous system, has emerged as a potential physiological link connecting these seemingly disparate symptoms. Methods: This literature review systematically synthesized recent evidence from peer-reviewed publications, with a primary focus on research published after 2020, to investigate the intricate, bidirectional relationship between HRV, sleep, and cognition in the context of epilepsy. Results: The findings consistently demonstrate that patients with epilepsy exhibit significantly lower HRV compared to healthy controls, reflecting a persistent state of sympathetic dominance. This underlying autonomic imbalance is identified as a central pathophysiological mechanism that not only contributes to poor sleep quality and cognitive deficits but also increases the risk of Sudden Unexpected Death in Epilepsy (SUDEP). This review posits. HRV as a crucial, non-invasive biomarker for comprehensive risk stratification, suggesting that targeted interventions aimed at restoring autonomic balance, such as cognitive behavioral therapy for insomnia (CBT-I) and vagus nerve stimulation (VNS), hold significant promise for improving overall patient quality of life. Conclusion: this review establishes low HRV as a key marker of a shared pathological mechanism in epilepsy, linking seizure activity with critical sleep and cognitive comorbidities. The potential of HRV as a non-invasive, scalable biomarker for multifaceted risk assessment is substantial. Future research should prioritize large-scale longitudinal studies and controlled trials to standardize HRV measurement and validate targeted interventions that restore autonomic balance, ultimately moving towards a more holistic patient management paradigm.
IMPROVING FAMILY RESILIENCE IN PRIMARY AND SECONDARY STROKE PREVENTION THROUGH LIFE'S ESSENTIAL 8-BASED INTERVENTION Arisetijono, Eko; Yueniwati, Yuyun; Damayanti, Ria; Ernanda, Shelby Amrus; Savitri, Kania Aviandi; Romadhoni, Muhammad Rifqy; Taqiyyah, Masyalia Hasna; Haq, Nabiila Ala Qoonita Najma; Sinaga, Alexandra Maria Rossadwina Sriharkita; Alam, Satria Sabda; Zahra, Farah Shabri Alifia; Pranowo, Muhammad Royyan; Raihana, Naura Salwa; Siraj, Resnanda Naufal
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.02.24

Abstract

Background: Stroke is a leading cause of long-term disability in Indonesia, with rising incidence among individuals of productive age. Rural communities face multiple challenges, including low health literacy, high prevalence of risk factors, and persistent misconceptions about stroke prevention and post-stroke care. Objective: This study aimed to evaluate the effectiveness of a community-based intervention using the Life’s Essential 8 (LE8) framework and the SIGAP 8 pocket-book to strengthen family preparedness for primary and secondary stroke prevention in Besole Village, Tulungagung. Methods: A mixed-methods approach was applied in two phases: (1) pre-intervention assessment through demographic surveys, in-depth interviews, and FGDs with stakeholders to identify community needs; and (2) intervention through structured education, health screening, and pre–post knowledge testing. Participants underwent measurements of blood pressure, BMI, glucose, cholesterol, WHO stroke risk assessment, and Barthel Index evaluation for survivors. User experience of the SIGAP 8 booklet was assessed using the User Experience Questionnaire (UEQ). Results: A total of 34 stroke survivors and 21 non-stroke participants were included. Among survivors, 58.8 percent had stage 2 hypertension and 26.5 percent had glucose ≥200 mg/dL. Most demonstrated moderate dependence on the Barthel Index. Among non-stroke participants, 57.1 percent were classified as moderate risk. UEQ scores indicated positive user experience across dimensions, including dependability (3.82), attractiveness (3.69), and clarity (3.67). The LE8-based intervention effectively improved health literacy, motivation, and family capacity in monitoring stroke risk factors. Conclusion: The SIGAP 8 pocket-book was well-received and shows strong potential as a community-level tool for stroke prevention in rural areas.
SENSITIVITY, PRECISION, AND F1 SCORE OF WEARABLE DEVICES IN ABSENCE SEIZURE MONITORING: A SYSTEMATIC REVIEW Amri, Zidan Dzulyadain; Setyoadji, Yusuf Omar; Sadinah, Fahrin; Ernanda, Shelby Amrus; Damayanti, Ria
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.02.12

Abstract

Background: Absence seizure is one of the most common forms of generalized epilepsy. Wearable devices have been proposed as useful tools to improve clinical care by providing continuous monitoring of patients. This study aimed to evaluate the use of wearable devices for detecting and monitoring absence epilepsy. Methods: This systematic review was performed using PRISMA standards and included cohort studies investigating wearable devices as monitoring tools for absence epilepsy. Literature searches were performed in PubMed, Science Direct, Cochrane, and Google Scholar. Results: Eleven cohort studies published between 2012 and 2025 from France, Turkey, Portugal, Netherlands, Denmark, Belgium, Georgia, USA, and Boston were included, with a total of 1,305 participants. All studies assessed wearable devices for detecting absence seizures and reported diagnostic performance using sensitivity, precision, and F1 score. The pooled descriptive synthesis showed a mean sensitivity of 0.897 (range 0.791–1.000; 11 studies), a mean precision of 0.831 (range 0.540–0.950; 7 studies), and a mean F1 score of 0.858 (range 0.740–0.9639; 7 studies). Only descriptive analysis was possible as most studies did not provide raw diagnostic data or confidence intervals. Conclusion: Wearable devices demonstrate promising performance in detecting absence seizures among patients with absence epilepsy, with high sensitivity, acceptable precision, and overall robust F1 scores across the included studies. However, the lack of standardized data reporting and confidence intervals limits the possibility of meta-analysis. Further large-scale prospective studies are required to validate these findings and support clinical implementation.
CLINICAL SPECTRUM AND DIAGNOSTIC OF NEUROFIBROMATOUS IN YOUNG AGES: SERIAL CASE Rahmaditta, Allyssa; Rahmawati, Dessika
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.02.21

Abstract

Background: Neurofibromatosis and schwannomatosis are neurocutaneous syndromes characterized by a genetic predisposition to the formation of Schwann cell tumors. Phenotypic overlap between NF2 (Neurofibromatosis Type 2)-related schwannomatosis and non-NF2 schwannomatosis often presents diagnostic challenges. Objective: To report two cases of neurofibromatosis in young patients with distinct clinical manifestations, highlighting diagnostic and therapeutic aspects. Contents: A case series study involving two patients diagnosed with neurofibromatosis at Dr. Saiful Anwar General Hospital, Malang, in 2025. Data were collected from anamnesis, physical examination, and ancillary tests including radiologic and histopathologic evaluations, followed by analysis to establish diagnosis and treatment planning. The first case, a 30-year-old male, presented with progressive limb weakness and bilateral hearing loss. MRI revealed bilateral vestibular schwannomas and multiple intradural schwannomas, consistent with NF2-related schwannomatosis. The second case, a 30-year-old female, experienced multiple neuropathic pain sites and tender subcutaneous nodules. Biopsy confirmed neurofibroma, consistent with non-NF2 schwannomatosis. Management included decompressive surgery and symptomatic therapy. Conclusion: Clinical manifestations of NF2 and schwannomatosis often overlap; thus, an integrated approach combining clinical, radiologic, histopathologic, and genetic findings is essential for accurate diagnosis. A multidisciplinary approach is required to optimize prognosis.  
OVERLAPPING PONTINE SYNDROME SYMPTOMATOLOGY: A RUPTURED CEREBELLAR PEDUNCLE ARTERIOVENOUS MALFORMATION Abrar, Muhammad Nabil; Danishara, Mahawikan Akmal; Putra, Gabriel Zefanya Handoko; Addimaysqi, Rafi; Adrianto, Yudhi
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.02.23

Abstract

Background: Localizing brainstem lesions depends on identifying specific clinical syndromes. In the pons, the commonly confused Millard-Gubler and Foville syndromes share similar features. Millard-Gubler syndrome arises from a ventral pontine lesion, causing ipsilateral CN VII and CN VI palsies with contralateral hemiparesis while preserving conjugate gaze. In contrast, Foville syndrome involves a dorsal pontine lesion and is distinguished by ipsilateral conjugate gaze palsy due to pontine gaze center involvement. Case Report:  This case describes a 56-year-old female patient with neurological deficits of crossed hemiparesis manifested by left-sided hemiparesis, hemihypesthesia and right-sided lower motor facial palsy, pathognomonic for a brainstem syndrome. Computed tomographic angiography (CTA) imaging revealed a cerebellar peduncle arteriovenous malformation (AVM) rupture with an intranidal aneurysm related to the brainstem syndrome. The anatomical lesion and clinical manifestations are considerably consistent with the definitions of Millard-Gubler and Foville syndrome. Upon DSA, the intranidal aneurysm was spontaneously thrombosed, leading to a decision to leave the AVM without intervention. Discussion: The clinical manifestations of ventrocaudal pontine lesions include Millard-Gubler and  Foville syndromes. In this patient, involvement of the ventrocaudal and dorsomedial pons affected the abducens nucleus, facial colliculus, and corticospinal tract, producing overlapping Millard-Gubler and Foville features. Unlike typical ischemic or hemorrhagic pontine syndromes, this presentation resulted from secondary pontine hemorrhage due to a ruptured cerebellar peduncle AVM. Spontaneous thrombosis of the AVM nidus further created a therapeutic dilemma given its poorly defined natural history. Conclusion: This case illustrates that classic brainstem syndromes may arise from rare structural causes such as AVMs and highlights spontaneous thrombosis as a rare event complicating management. Recognition of atypical etiologies and the use of comprehensive neuroimaging are essential for accurate diagnosis and identification of potentially treatable vascular lesions.
CLINICAL PROFILE OF STROKE SEVERITY BASED ON NIHSS, MORTALITY, AND PNEUMONIA INCIDENCE AMONG FEMALE STROKE PATIENTS Arisetijono, Eko; Putri, Adecya Amaryllis Risa; Andarini, Sri; Agustin, Aisyiyah Alviana
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.02.07

Abstract

Background: Stroke is a leading cause of mortality and long-term disability worldwide, with women exhibiting distinct clinical characteristics and generally poorer outcomes than men. Female-specific risk factors, older age at onset, and greater stroke severity contribute to unfavorable prognoses. As a tertiary referral center in East Java, Dr. Saiful Anwar General Hospital treats a large number of female stroke patients, yet comprehensive clinical data remain limited. Objective: To describe the clinical profile of female stroke patients, focusing on stroke severity based on NIHSS scores, mortality, and pneumonia incidence. Methods: This retrospective descriptive study included 202 female stroke patients admitted between January and December 2024. Data were extracted from electronic medical records. Results: Most patients were aged 45–64 years (46.5%) or ≥65 years (44.6%), and the majority were housewives (80.2%). Thrombotic stroke predominated (55.4%) over intracerebral hemorrhage (44.6%). Hypertension was the most prevalent vascular risk factor (96.0%), followed by diabetes mellitus (42.1%), dyslipidemia (35.1%) and heart disease (32.2%). Stroke severity was predominantly moderate to very severe, with 91.1% of patients presenting with NIHSS scores ≥5. Pneumonia was the most frequent complication (51.5%). Overall mortality reached 45.0%. Conclusion: Female stroke patients demonstrated a high burden of vascular risk factors, severe neurological impairment, frequent complications, and mortality far exceeding global averages. These findings highlight the urgent need for strengthened prevention strategies, improved acute stroke care, early complication management, and targeted interventions for this vulnerable population.
SYNCHRONOUS BRAIN AND LUNG TUBERCULOMA: A CASE SERIES Ibrahim, Sabri; L, Lina
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.02.22

Abstract

Background: Brain tuberculoma is a rare manifestation of tuberculosis that is considered one of the most severe cases of tuberculosis. In this case series, clinical features, radiological findings, and management of the tuberculomas are discussed. Case report: We report three cases of synchronous brain and lung tuberculomas that present different symptoms but demonstrate the same pattern of ring enhancement in brain radiological findings and nodule with consolidation on chest X-ray imaging. Two out of three cases underwent craniotomy tumor removal surgery, and the other one had a ventriculoperitoneal shunt placement as an emergency life-saving procedure due to elevated intracranial pressure caused by mass effect of the tuberculoma and started anti-tuberculosis medication subsequently. Conclusion: Brain tuberculomas should always be considered in the differential diagnosis of single or multiple space-occupying brain lesions in tuberculosis-endemic areas or in individuals with a history of prior tuberculosis exposure or infection. Prompt diagnostic investigations, along with pharmacological and possible adjuvant surgical treatment, are required in brain tuberculomas management.
INTEGRATION OF ACUPUNCTURE AND STANDARD MEDICAL TREATMENT FOR A GERIATRIC PATIENT WITH POST-PAROTIDECTOMY FACIAL NERVE PARALYSIS: A CASE REPORT Supriyana, Dwi Surya; Prasetyawati, Arsita Eka; Budianto, Pepi
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.02.19

Abstract

Background: Acupuncture is an established treatment for peripheral facial nerve paralysis, but optimal management of post-parotidectomy facial nerve paralysis in the geriatric population remains uncertain. Case Report: A 60-year-old man developed right facial nerve paralysis following parotidectomy and received integrated care from a medical acupuncturist, neurologist, and family physician with corticosteroids, mecobalamin, other oral medications, and acupuncture. Electroacupuncture (EA) and manual acupuncture (MA) were given twice weekly for 30-minute sessions (28 sessions), resulting in progressive improvements: lagophthalmos resolved by session 7, mouth symmetry improved by session 20, and eyebrow movement was stored by session 28. Conclusions: House-Brackmann Facial Nerve Grading System (HBFNGS) and nerve conduction velocity (NCV) testing demonstrated functional recovery, suggesting that combined electroacupuncture, manual acupuncture, and pharmacotherapy may be effective for post-parotidectomy facial nerve paralysis.
MOBILISATION TIMING AND INTENSITY AFTER ACUTE ISCHEMIC STROKE: BAYESIAN NETWORK META-ANALYSIS Lunita, Angelina Ernestine Putri; Rumapea, Vivi Kristiani; Togatorop, Pascanus Lamsihar Parluhutan; Boy, Togu Deny; Sonya, Marta; Ekaputra, Anthony
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.02.16

Abstract

Background: Mobilisation after acute ischemic stroke is commonly practiced, yet the optimal timing and intensity remains uncertain. The AVERT trial (A Very Early Rehabilitation Trial) raised concerns regarding very-early and high-intensity mobilisation, but no prior synthesis has jointly compared timing–intensity strategies. Objective: To compare the effectiveness of mobilisation strategies classified by AVERT timing–intensity criteria and evaluate safety outcomes. Methods: We systematically searched through indexed search engines for randomised controlled trials. The primary outcome was favourable functional recovery at 90 days (modified Rankin Scale 0–2). Risk of bias was assessed using Cochrane RoB-2. A Bayesian random-effects network meta-analysis was performed with treatment ranking using surface under the cumulative ranking curve (SUCRA) and consistency assessed by node-splitting. Safety outcomes (complications and mortality) were summarised using direct comparisons with odds ratios (ORs) and forest plots. Results: Eight trials (n = 813) formed a connected network of six mobilisation strategies. Moderate-intensity mobilisation showed the highest probabilities of favourable outcomes across initiation timings. Also, early–moderate mobilisation was more favorable compared to delayed–moderate mobilisation (OR 2.14; 95% CrI 1.14–4.13). The Surface Under the Cumulative Ranking (SUCRA) curve placed moderate intensity strategies higher. Conclusion: Mobilisation delivered at a moderate intensity (3-6 sessions per day and 20-40 minutes/day) is associated with the highest probability of improved functional recovery at 90 days, when accompanied by careful monitoring and avoidance of very early and high-intensity mobility within the first 24-72 hours. Safety data were heterogeneous and needed standardised adverse-event reporting.
PIMPINELLA PRUATJAN MOLK. AS A POTENTIAL ANTI-DIABETIC NEUROPATHY WITH ANTIOXIDANT MECHANISMS: A REVIEW Dewi, Trisni Untari; Mondiani, Yeni Quinta; Rukmi, Kartika Widya; Munawaroh, Fauziyatul; Rusmajati, Jetty; Batubara, Irmanida
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2026.012.02.17

Abstract

Medicinal plant utilization in the clinical management of metabolic disorders, including Diabetes Mellitus (DM) and its associated complications, has gained considerable scientific attention in recent decades. Their perceived tolerability positions them as viable complementary or adjunct options to standard pharmacological regimens. Purwoceng (Pimpinella pruatjan Molk.) is a plant indigenous to Indonesia that demonstrates notably high concentrations of antioxidant constituents. Given that oxidative stress constitutes a fundamental driver in the pathophysiology of DM, it is implicated in the development of complications including diabetic peripheral neuropathy. Objective: To review existing evidence on the potential of purwoceng in reducing blood glucose levels and repairing nerve damage in diabetic neuropathy, including its mechanisms, active compounds, and toxicity profile. Methods: A literature review was conducted using keywords including Pimpinella pruatjan/Molk, Purwoceng, Antioxidant, Diabetes Mellitus, Diabetic Neuropathy, and secondary metabolites. Relevant studies were selected and critically reviewed. Results: Several studies identified secondary metabolites in purwoceng, including phenolics, flavonoids, tannins, coumarins, saponins, terpenes, and steroids. These compounds exhibit antioxidant and anti-inflammatory properties, suggesting potential benefits in reducing hyperglycemia and preventing or repairing nerve damage in diabetic neuropathy. Available evidence also indicates no significant acute toxicity in renal and hepatic organs. Conclusion: Purwoceng exhibits promising potential as an adjunctive therapeutic agent in the management of Diabetes Mellitus and its neuropathic complication, mediated principally through antioxidant and anti-inflammatory mechanisms, with a favorable preliminary safety profile. Rigorous clinical investigations are warranted to substantiate its efficacy and safety in human subjects.

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