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All Journal Jurnal Kedokteran Diponegoro International Islamic Medical Journal
Puspamaniar, Vania Ayu
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Case Report: Ischaemic Stroke Presented with Hemichorea-Hemiballism Ariobimo, Bonfilio Neltio; Puspamaniar, Vania Ayu; Nujum, Nurun; Puspitorini, Lisa
Jurnal Medis Islam Internasional Vol 5 No 1 (2023): December
Publisher : UNUSA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/iimj.v5i1.4911

Abstract

Introduction: Movement disorders can be separated into hypokinetic disorders, which cause paucity or slowness (bradykinesia), and hyperkinetic disorders, which cause excessive, aberrant involuntary motions Less than 5% of individuals with cerebrovascular diseases presented with involuntary movement. It might be difficult to identify and diagnose hyperkinetic disorders. Case: We describe a 56-year-old man who arrived at the hospital with 5 hours of abrupt, uncontrollable movement in his right upper and lower limbs. A complete neurological evaluation revealed an uncontrolled, nonrhythmic, non-patterned, aimless, and frequently jerky movement of the right upper and lower limbs with a ballistic component that varies in amplitude and frequency. Higher psychic function and cranial nerves were normal. Chest radiography, electrocardiography were normal. Hemorrhage was ruled out by a brain non-contrast CT scan at admission. The patient was diagnosed with hemichorea-hemiballism caused by an ischemic stroke based on clinical evidence of a sudden neurological deficit of aberrant involuntary movement. After receiving medical treatment for five days, the involuntary motions stopped occurring without causing any more neurological abnormalities or weakening. Discussion: Ischemic stroke diagnosis relied on skilled clinical assessment without explicit neuroimaging. While hemiballismus is characterized by violent irregular flinging movements of the limbs brought on by contractions of the proximal muscles, hemichorea consists of continuous random, anarchic, and jerking movements involving both the distal and proximal muscles (though it is occasionally localized more distally). Conclusion : Hyperkinetic movement disorders are a rare presentation of stroke. The pathophysiology of these abnormal movements remains uncertain. Even though they are uncommon, following a stroke, aberrant motions can occur suddenly or develop gradually. Hemichorea-hemiballismus with abrupt onset should be treated as an acute stroke unless proven other causes
The Role of Midazolam on Status Epilepticus: Systematic Review Firdha, Azizah Amimathul; Puspamaniar, Vania Ayu; Machin, Abduloh
Jurnal Kedokteran Diponegoro (Diponegoro Medical Journal) Vol 12, No 6 (2023): JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL)
Publisher : Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dmj.v12i6.38806

Abstract

Background: Status epilepticus is a condition that results either in the failure of the mechanisms responsible for stopping seizures or in initiating mechanisms that cause seizures to be abnormally prolonged. Benzodiazepine is the first-line therapy for status epilepticus. The three usually used Benzodiazepines are Lorazepam, diazepam, and midazolam. Objective: This systematic review was undertaken to determine midazolam's role in managing patients with status epilepticus. Methods: A systematic search from PubMed, Science Direct, and Cochrane was conducted with predetermined keywords. Studies in randomized controlled trials assessing the impact of midazolam on epileptic status were included in the inclusion criteria. Articles are published in English, and the full text is accessible. The authors independently extracted data and assessed the risk of bias for each included study. Results: Of 6410 studies obtained from the search results, 13 studies were found that were relevant and matched the inclusion criteria. Benzodiazepines are the first line of SE therapy in an emergency. This group works by inhibiting GABA receptors and has a rapid effect in stopping seizures. Midazolam can be given intravenously, intramuscularly, or transmucosal (nasal, buccal, or rectal). Intravenous midazolam may be a good choice because of its short onset of action and, therefore, can effectively stop seizures. Conclusion: Effective and safe results have been seen with each Midazolam administration method. This suggests that Midazolam may be an excellent therapeutic option for SE. However, the type of Midazolam administration can be adjusted according to the guidelines and drug availability in each country. 
Co-Authors Ariobimo, Bonfilio Neltio Firdha, Azizah Amimathul Machin, Abduloh Nujum, Nurun Puspitorini, Lisa