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All Journal Asian Australasian Neuro and Health Science Journal (AANHS-J)
Dwi Herawati Ritonga
Department of Pediatrics, RSUD Deli Serdang, Lubuk Pakam, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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Journal : Asian Australasian Neuro and Health Science Journal (AANHS-J)

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The Neuromodulator Effect of Vagal Nerve Stimulation as the Treatment of Medically Refractory Epilepsy in Comparison with Surgical Approach: A Systematic Review Muhammad Al Anas; Dwi Herawati Ritonga
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 4 No. 1 (2022): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v4i1.8477

Abstract

Background: Restorative options in medically refractory epilepsy are restricted to ablative brain surgery, the trial of antiepileptic medications, or palliative procedures. Vagal nerve stimulation (VNS) is an accessible palliative method of which the mechanism of action isn't well understood, yet with set up adequacy for medically refractory epilepsy and low occurrence of incidental effects. Objectives: This systematic review aimed to evaluate the action of epilepsy treatment options. Methods: We searched for relevant studies published in 2016-2021 with PRISMA charts. For English published statistical analyses, we include all studies conducted on pediatric epileptic patients who have undergone epilepsy surgery and VNS. Results: Antiepileptic impacts of VNS incorporate expanded movement of the locus coeruleus (LC) neurons with a raised norepinephrine (NE) discharge in the hippocampus, cortex, and amygdala. VNS-modulatory consequences for other synapse frameworks such as cholinergic, GABAergic, and glutamatergic depend on the activation of the LC-NE pathway. While in pediatric epilepsy, early surgical intervention is frequently recommended to work on cognitive and behavioral outcomes that unequivocally portray the epileptogenic zone. Conclusion: The general rate of complication caused by epilepsy surgery was sensibly low (5%), suggesting that epilepsy medical procedures, particularly primarily temporal lobe resection, can be safe preferably with recent procedure options, while VNS could be more effective as therapy begins at early stages pre- or post-seizure onset to decide the preventative role of VNS in human epileptogenesis when the treatment is given promptly.
Cerebral Hemorrhage with Edema in A Five-Week-Old: A Case of Late-Onset Vitamin K Deficiency Bleeding, Rare Diagnosis in Resource-Limited Settings Muhammad Al Anas; Dwi Herawati Ritonga
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 5 No. 1 (2023): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v5i1.11040

Abstract

Introduction: Vitamin K deficiency bleeding (VKDB) is a term that describes the condition of hemorrhagic disorders in newborns. Late-onset VKDB occurs between the second week and sixth month of life. Intracranial hemorrhage often occurs in cases of late-onset VKDB and can cause 14-20% mortality and 40% long-term neurological morbidity, so it is important to treat patients until they are stable, especially with limited health facilities. Case Report: A baby boy aged 1 month 8 days was brought by his parents to RSUD Deli Serdang Lubuk Pakam with the chief complaint of an enlarged stomach, accompanied by paleness, weakness, convulsions, and altered consciousness. A midwife assisted the delivery with unknown history of immediate vitamin K injection after birth. We diagnosed the patient with VKDB according to the clinical symptoms. The head CT scan showed subdural and subarachnoid hemorrhage with cerebral edema. We transfused the patient with Packed Red Cells and Fresh Frozen Plasma 20 cc/12 hours 5 times, administered Vitamin K injection 3 mg/IM for 3 days, and other supportive therapy. The patient's condition improved within the third day of hospitalization with recovered consciousness and was transferred to the referral hospital. Discussion: The key feature of late-onset VKDB is the incidence of ICH in 30-88% of patients, leading to a high incidence of mortality. This study highlights the importance of prompt, and early treatment of VKDB with proper history taking, clinical examination, and relevant investigations to reduce morbidity and mortality. Conclusion: In conclusion, secondary late-onset PDVC is more common than the primary subtype, and late-onset PDVC is still an important cause of morbidity and mortality in developing countries including Indonesia, where vitamin K prophylaxis is not routinely performed
Co-Authors Muhammad Al Anas