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FENOMENA PSIKOSIS PADA PASIEN EPILEPSI: GAMBARAN KLINIS DAN TATALAKSANA Ria Damayanti; Machlusil Husna; Lovita Meika Savitri; Nur Izzati
Callosum Neurology Vol 4 No 1 (2021): Callosum Neurology Journal
Publisher : The Indonesia Neurological Association Branch of Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29342/cnj.v4i1.132

Latar Belakang: Epilepsi terjadi akibat lepasnya muatan listrik yang berlebihan, paroksismal dan abnormal pada neuron otak. Kelainan di bidang psikiatri seringkali muncul bersama dengan epilepsi. Hampir 20% sampai 60% pasien epilepsi memiliki beberapa jenis komorbiditas psikiatri. Kelainan di bidang psikiatri yang paling umum pada pasien epilepsi adalah depresi, ansietas dan psikotik. Tujuan: Pada artikel ini akan dibahas mengenai epilepsi dengan komorbiditas psikiatri terutama psikosis dari tinjauan klinis, patofisiologi dan manajemen yang direkomendasikan, sehingga dapat memperbaiki kualitas hidup pasien epilepsi secara umum. Diskusi: Secara umum psikosis epilepsi diklasifikasikan berdasarkan hubungannya dengan kejang yang yaitu iktal psikosis, postiktal psikosis dan interiktal psikosis. Epilepsi dengan komorbiditas psikiatri diduga disebabakan oleh faktor neuropatologi, neurokimia, genetik, dan psikososial. Simpulan: Pengetahuan khusus diperlukan untuk pemilihan obat anti epilepsi (OAE) pada pasien epilepsi dengan psikosis karena seringkali terjadi interaksi obat, efek sinergi, serta efek samping yang tidak diharapkan. Kata Kunci: Manajemen Psikosis, Epilepsi, Anti Psikotik, Anti Epilepsi

DANDY-WALKER VARIANT (DWV) IN 70 YEARS OLD WOMAN WITH DISEQUILIBRIUM AND CENTRAL VERTIGO : A CASE REPORT Ria Damayanti; Muhammad Welly Dafif; Shahdevi Nandar Kurniawan; Badrul Munir; Zamroni Afif
Journal of Pain, Headache and Vertigo Vol. 1 No. 1 (2020): March
Publisher : Journal of Pain, Headache and Vertigo

Dandy Walker Syndrome (DWS) and its Variants (DWV) is a congenital disorder that has prevalence of 1 in 25,000 to 30,000 births with the highest incidence occurs at age <1 year. However, patients may be diagnosed with DWS/DWV for the first time in adolescence and even old age. We reported the 70-year-old woman with a chief complaint of central type vertigo accompanied by disequilbrium. From history taking we obtained disequilibrium with gradual onset started in nine months and become settled since the last 6 months before she came to the neurology clinic. The patient also complained vertigo that have emerged since the last 3 month. A history of head trauma, stroke, dementia was denied. Physical examinaton show central nystagmus while other cranial nerve within normal range. Motor, sensory and autonomic status within normal range. Romberg test, tandem walking, disdiadokokinesia, and dismetria examination shows abnormal respons. MMSE results for patients within normal range (score:26). Head MRI shows Dandy Walker Variant in the accompanied by cerebral atrophy and degeneration serebelli Fazekas grade I. Patients receive symptomatic therapy betahistine mesylate 3x6 mg if necessary. Surgery management is not indicated because there is no sign of hydrocephalus or signs of increased intracranial pressure.

MENIEREâ€™S DISEASE Helena Era Millennie; Badrul Munir; Zamroni Afif; Ria Damayanti; Shahdevi Nandar Kurniawan
Journal of Pain, Headache and Vertigo Vol. 2 No. 1 (2021): March
Publisher : Journal of Pain, Headache and Vertigo

Meniereâ€™s disease is a disorder of the inner ear resulting in symptoms of episodic vertigo, tinnitus, hearing loss and aural pressure. Although the exact etiology is uncertain, it is associated with raised pressure in the endolymph of the inner ear (endolymphatic hydrops). The diagnosis of Meniere's disease is based on the clinical setting of the patient. This disease usually presents with unilateral ear symptoms but can be also bilateral. Meniere's disease attacks are usually random and episodic (approximatelyÂ 6-11 per year), with periods of remission that can last from months to years. Investigations are audiometry, electronystagmogram, vestibular evoked myogenic potentials (VEMPs) and imaging.The management consist pharmacological and non pharmacological. Meniere's disease is initially progressive but fluctuates unexpectedly. It is difficult to distinguish natural resolutions from treatment effects.

COMPARISON OF HYDRODISECTION INJECTION BETWEEN TRIAMCINOLONE ACETONIDE VERSUS DEXAMETHASONE IN CARPAL TUNNEL SYNDROME Widodo Mardi Santoso; Badrul Munir; Catur Ari Setianto; Ria Damayanti; Sheny Agma
Journal of Pain, Headache and Vertigo Vol. 2 No. 2 (2021): September
Publisher : Journal of Pain, Headache and Vertigo

Background: Carpal tunnel syndrome (CTS) is the most common nontraumatic peripheral neuropathy, which is caused by suppression of the median nerve below the transverse carpi ligament. Local corticosteroid injection is considered the fastest and most effective method for improving symptoms that occur in CTS. There are several corticosteroid agents that can be used, but there are no objective standards that can explain the most ideal drugs. Objective: To compare the effectiveness of hydrodisection injection therapy of triamcinolone acetonide versus dexamethasone on carpal tunnel syndrome. Methods: This study involved 30 participants who were diagnosed with CTS and fulfilled the inclusion criteria and no exclusion criteria were obtained. Participants were divided into two treatment groups; the first group (n = 15) injected with Triamcinolone Acetonide (TCA) 10mg / 1ml and lidocaine 1% 1 ml and the second group (n = 15) injected with Dexamethasone 4mg / 0.8ml and lidocaine 1% 1 ml. The NRS, FSS, and SSS parameters were assessed before injection and 4 weeks after injection in each agent. Then compared these parameters at 4 weeks after injection compared to the TCA group with the dexamethasone group. Results: NRS score before and 4 weeks after TCA injection (sig 0.000; p <0.05), SSS (sig 0.001; p <0.05) and FSS (sig 0.020; p <0.05), and NRS score before and 4 weeks after dexamethasone injection (sig 0.001; p <0.05), SSS (sig 0,000; p <0.05) and FSS (sig 0,000; p <0.05). At 4 weeks after injection of TCA compared to dexamethasone there were no significant results on NRS (sig 0.237; p> 0.05) and FSS (sig 0.119; p> 0.05), while SSS values were significantly different (sig 0.027; p <0.05). Conclusion: Significant improvement in NRS, FSS and SSS score was obtained at 4 weeks after hydrodisection injection, both with TCA and dexamethasone. At 4 weeks after TCA injection compared to dexamethasone, there were no significant differences in NRS and FSS scores, whereas SSS score differed significantly. Both injection agents are equally effective in treating CTS, but dexamethasone produces a better improvement in SSS score.

DEALING WITH UNCONTROLLED SEIZURE IN CATAMENIAL EPILEPSY: A CASE REPORT Machlusil Husna; I Wayan Arsana Wiyasa; Ria Damayanti; Syah Sembung Wasiso; Fahimma Fahimma; Kartika Agustina
MNJ (Malang Neurology Journal) Vol. 9 No. 1 (2023): January
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.2023.009.01.16

Catamenial epilepsy refers to a seizure pattern that coincides with the menstrual period. Patients with catamenial epilepsy often leads to intractable epilepsy and may have an adverse impact on quality of life. Several medications are the therapeutic options, however, there is uncertainty regarding the best treatment, and these medications often fail to control the seizure. This makes catamenial epilepsy categorized as pharmaco-resistant epilepsy. This paper reported a case of perimenstrual catamenial epilepsy with an uncontrolled seizure problem. Seizures still occur with optimal management, and thereby clinicians must continue to re-evaluate clinical conditions and treatment selection to achieve optimal management. Personalized-based treatment should be considered in catamenial epilepsy management. This report discusses the challenges of catamenial epilepsy, understanding the catamenial process, and dealing with the problem with a practical personalized approach.

DANDY-WALKER VARIANT (DWV) IN 70 YEARS OLD WOMAN WITH DISEQUILIBRIUM AND CENTRAL VERTIGO : A CASE REPORT Ria Damayanti; Muhammad Welly Dafif; Shahdevi Nandar Kurniawan; Badrul Munir; Zamroni Afif
Journal of Pain, Headache and Vertigo Vol. 1 No. 1 (2020): March
Publisher : Journal of Pain, Headache and Vertigo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jphv.2020.001.01.2

Dandy Walker Syndrome (DWS) and its Variants (DWV) is a congenital disorder that has prevalence of 1 in 25,000 to 30,000 births with the highest incidence occurs at age <1 year. However, patients may be diagnosed with DWS/DWV for the first time in adolescence and even old age. We reported the 70-year-old woman with a chief complaint of central type vertigo accompanied by disequilbrium. From history taking we obtained disequilibrium with gradual onset started in nine months and become settled since the last 6 months before she came to the neurology clinic. The patient also complained vertigo that have emerged since the last 3 month. A history of head trauma, stroke, dementia was denied. Physical examinaton show central nystagmus while other cranial nerve within normal range. Motor, sensory and autonomic status within normal range. Romberg test, tandem walking, disdiadokokinesia, and dismetria examination shows abnormal respons. MMSE results for patients within normal range (score:26). Head MRI shows Dandy Walker Variant in the accompanied by cerebral atrophy and degeneration serebelli Fazekas grade I. Patients receive symptomatic therapy betahistine mesylate 3x6 mg if necessary. Surgery management is not indicated because there is no sign of hydrocephalus or signs of increased intracranial pressure.

MENIEREâ€™S DISEASE Helena Era Millennie; Badrul Munir; Zamroni Afif; Ria Damayanti; Shahdevi Nandar Kurniawan
Journal of Pain, Headache and Vertigo Vol. 2 No. 1 (2021): March
Publisher : Journal of Pain, Headache and Vertigo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jphv.2021.002.01.5

Meniereâ€™s disease is a disorder of the inner ear resulting in symptoms of episodic vertigo, tinnitus, hearing loss and aural pressure. Although the exact etiology is uncertain, it is associated with raised pressure in the endolymph of the inner ear (endolymphatic hydrops). The diagnosis of Meniere's disease is based on the clinical setting of the patient. This disease usually presents with unilateral ear symptoms but can be also bilateral. Meniere's disease attacks are usually random and episodic (approximatelyÂ 6-11 per year), with periods of remission that can last from months to years. Investigations are audiometry, electronystagmogram, vestibular evoked myogenic potentials (VEMPs) and imaging.The management consist pharmacological and non pharmacological. Meniere's disease is initially progressive but fluctuates unexpectedly. It is difficult to distinguish natural resolutions from treatment effects.

COMPARISON OF HYDRODISECTION INJECTION BETWEEN TRIAMCINOLONE ACETONIDE VERSUS DEXAMETHASONE IN CARPAL TUNNEL SYNDROME Widodo Mardi Santoso; Badrul Munir; Catur Ari Setianto; Ria Damayanti; Sheny Agma
Journal of Pain, Headache and Vertigo Vol. 2 No. 2 (2021): September
Publisher : Journal of Pain, Headache and Vertigo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jphv.2021.002.02.1

Background: Carpal tunnel syndrome (CTS) is the most common nontraumatic peripheral neuropathy, which is caused by suppression of the median nerve below the transverse carpi ligament. Local corticosteroid injection is considered the fastest and most effective method for improving symptoms that occur in CTS. There are several corticosteroid agents that can be used, but there are no objective standards that can explain the most ideal drugs. Objective: To compare the effectiveness of hydrodisection injection therapy of triamcinolone acetonide versus dexamethasone on carpal tunnel syndrome. Methods: This study involved 30 participants who were diagnosed with CTS and fulfilled the inclusion criteria and no exclusion criteria were obtained. Participants were divided into two treatment groups; the first group (n = 15) injected with Triamcinolone Acetonide (TCA) 10mg / 1ml and lidocaine 1% 1 ml and the second group (n = 15) injected with Dexamethasone 4mg / 0.8ml and lidocaine 1% 1 ml. The NRS, FSS, and SSS parameters were assessed before injection and 4 weeks after injection in each agent. Then compared these parameters at 4 weeks after injection compared to the TCA group with the dexamethasone group. Results: NRS score before and 4 weeks after TCA injection (sig 0.000; p <0.05), SSS (sig 0.001; p <0.05) and FSS (sig 0.020; p <0.05), and NRS score before and 4 weeks after dexamethasone injection (sig 0.001; p <0.05), SSS (sig 0,000; p <0.05) and FSS (sig 0,000; p <0.05). At 4 weeks after injection of TCA compared to dexamethasone there were no significant results on NRS (sig 0.237; p> 0.05) and FSS (sig 0.119; p> 0.05), while SSS values were significantly different (sig 0.027; p <0.05). Conclusion: Significant improvement in NRS, FSS and SSS score was obtained at 4 weeks after hydrodisection injection, both with TCA and dexamethasone. At 4 weeks after TCA injection compared to dexamethasone, there were no significant differences in NRS and FSS scores, whereas SSS score differed significantly. Both injection agents are equally effective in treating CTS, but dexamethasone produces a better improvement in SSS score.

FACTORS AFFECTING THE FUNCTIONAL STATUS OF PATIENT WITH MENINGIOMA IN DR. SAIFUL ANWAR GENERAL HOSPITAL MALANG Dessika Rahmawati; Badrul Munir; Nanik Setijowati; Catur Ari Setianto; Ria Damayanti; Bimo Mubyarto
MNJ (Malang Neurology Journal) Vol. 9 No. 1 (2023): January
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.2023.009.01.17

Background: Meningioma is one of the most commonly reported primary central nervous system (CNS) tumors, originating from arachnoid meningeal cells and including intracranial extra-axial neoplasms. Although meningioma is considerably benign, the patient conditions are reported to be diverse resulting in severe and life-threatening neurological deficits. Hence the assessment regarding functional status is deemed pivotal to provide a prognostic perspective as patient presentation exhibits disability due to lesions and other factors. Objective: This research aims to analyze factors affecting the functional status of patients with meningioma in Dr. Saiful Anwar General Hospital Malang. Methods: An analytic retrospective study was conducted with cross-sectional study involving 62 samples from patients visits with meningioma brain tumor in RSUD dr. Saiful Anwar General Hospital Malang from January 2017 to December 2020. The data was selected through non-probability sampling, generating sampling type from brain tumor register data Neurology. Results: Data obtained from 62 meningioma patients in RSUD dr. Saiful Anwar General Hospital Malang met the inclusion criteria from January 2017 to December 2020, based on demographic characteristics such as age of <50 in 38 patients (61.3%) and age of >50 in 24 patients (38.7%). Clinically, it was found that 58 patients (93.5%) experienced headache, 28 patients (45.2%) experienced decreasing consciousness, 15 patients (24.2%) had hemiplegia, and 17 patients (27.4%) had hemiparesis, 17 people had hemiparesis. 17 patients (27.4%) experienced visual disturbances, and 24 patients (38.7%) are with seizures. Based on the radiology screening sites, 46 patients (74.2%) were screened in Convexity sphere, 9 patients (14.5%) were screened at Cranial base, 3 patients (4.8%) were screened at Parasagittal, and 4 patients (6.5%) were screene at Falx, from which the 41 patients (66.1%) exhibited herniation. Based on comorbidities, 12 patients (19.4%) had sepsis, and 1 patient (1.6%) had pneumonia. From the analysis test results, it was found that decreasing consciousness (GCS) was significantly correlated with functional status, referred to Karnofsky Performance Scale of <70 (p: 0.013, p <0.05). Seizures were reported to be correlated significantly with functional status, referred to Karnofsky Performance Scale of > 70 (p: 0.015, p<0.05). Tumor location was significantly correlated with functional status, reffered to Karnofsky Performance Scale of > 70 (p: 0.027, p<0.05). Conclusion: The factors affecting the functional status based on the Karnofsky Performance Scale (KPS) of a patient with meningioma at Dr. Saiful Anwar General Hospital Malang included: decreasing consciousness (GCS), and seizures, and tumor location.

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