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HUBUNGAN MEAN ARTERIAL BLOOD PRESSURE DENGAN KELUARAN PASIEN STROKE TROMBOTIK YANG DINILAI DENGAN SKOR NIHSS Rahayu, Masruroh; Rakhmani, Alidha Nur; Raisa, Neila; Ar Rahmah, Kurnia Auliyana
Majalah Kesehatan FKUB Vol 5, No 3 (2018): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Hipertensi merupakan salah satu faktor risiko stroke. Beberapa penelitian menyatakan peningkatan tekanan darah sistol dan diastol pada stroke iskemik menyebabkan keluaran yang buruk pada pasien stroke. Namun berdasarkan penelitian lain, peningkatan tekanan darah sistemik memiliki efek proteksi sehingga menurunkan tingkat keparahan stroke. Penelitian ini bertujuan untuk mengetahui hubungan mean arterial blood pressure (MABP) dengan keluaran pasien stroke trombotik yang diukur dengan skor Delta National Institutes of Health Stroke Scale (NIHSS). Penelitian ini menggunakan subjek pasien stroke yang dirawat di Stroke Unit RS. Dr. Saiful Anwar Malang selama periode April - Juni 2016 dengan jumlah sample 30 pasien. Kriteria inklusi usia pasien >18 tahun, onset stroke <24 jam, dan diagnosis stroke dengan CT scan kepala sebagai gold standard. NIHSS dan tekanan darah diukur 24 jam pertama sejak terdiagnosis stroke dan NIHSS kembali diukur pada hari 14. Delta NIHSS didapatkan dari NIHSS hari ke 14 dikurangi NIHSS masuk. Penelitian ini menggunakan desain peneltian cross sectional. Berdasarkan hasil analisis didapatkan korelasi yang signifikan antara MABP dengan Delta NIHSS (p = 0,025, r = -0,408) dengan arah korelasi negatif. Semakin tinggi nilai MABP maka akan semakin negatif delta NIHSS. Semakin negatif nilai Delta NIHSS menunjukkan semakin baik klinis dari pasien stroke.Â Kata kunci: delta NIHSS, MABP, sistol, diastol, stroke.

THE INFLUENCE OF SAMPLING TIME TO SERUM GLIAL FIBRILLARY ACIDIC PROTEIN (GFAP) LEVELS IN ACUTE STROKE Raisa, Neila; Sujuti, Hidayat; Purnomo, Hari; Rahayu, Masruroh; Dalhar, Mochamad
Malang Neurology Journal Vol 5, No 1 (2019): January
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2019.005.01.5

Background: Serum Glial Fibrillary Acidic Protein (GFAP) is a great potential for biomarker that is widely studied as a diagnostic biomarker of acute stroke. Sampling within 6 hours after onset is the best time window, but in Indonesia, stroke patients often arrive late more than 6 hours.Objective: To identify the difference in time of blood sampling with serum GFAP levels within 24 hours onset of ischemic stroke (IS) patients and intracerebral hemorrhage (ICH) strokes.Methods: Cross-sectional analysis with purposive sampling, sampling in IS and ICH strokes that arrive at the ER within 24-hour on-site. The serum GFAP examination was performed with ELISA.Results: In this study, 41 acute stroke patients with 24-hour onset of each stroke were grouped into group 1 (<6 hours), group 2 (6-12 hours) and group 3 (12-24 hours). One Way ANOVA and Tukey's analysis showed no significant difference in GFAP levels among the three groups in both IS and ICH. Conclusion: There was no significant difference in GFAP levels in samples <6 hours, 6-12 hours, and 12-24 hours in ischemic strokes and ICH strokes.

THE SIDE EFFECTS OF CHEMOTHERAPY IN GLIOMA Raisa, Neila; Marhaendraputro, Eko Arisetijono
Malang Neurology Journal Vol 5, No 2 (2019): July
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2019.005.02.9

The increasing number of people who survive in the long term because of the advanced of glioma therapy with chemotherapy causes more slowly emerging neurologic side effects. Currently, there were three medical treatments are approved by the FDA for the management of glioblastoma namely temozolomide, carmustine wafer, and bevacizumab. However, most of the traditional chemotherapy drugs have a target in cell proliferation and cause toxicity of healthy cells. The side effects of chemotherapy on central nervous systems are chemobrain, acute encephalopathy, leukoencephalopathy, cerebellar dysfunction, and spinal cord toxicity. In addition, severe chemotherapy side effects may also occur in the peripheral nervous system called Chemotherapyinduced peripheral neuropathic pain (CIPNP). The clinician should recognize the symptoms of those side effect in glioma patients who received chemotherapy.

HEMICHOREA-HEMIBALLISM IN VARIOUS CONDITIONS: SERIAL CASE REPORTS Raisa, Neila; Rianawati, Sri Budhi; Kurniawan, Shahdevi Nandar; F, Fahimma; Fitria Nikmahtustsani, Mulika Ade
Malang Neurology Journal Vol 7, No 1 (2021): January
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2021.007.01.15

Introduction: Hemichorea-hemiballism (HCHB) is an uncommon movement disorder involved unilateral extremities characterized by irregular, poorly patterned, a continual hyperkinetic involuntary movement disorder in the proximal or distal parts of the body. The acute development of HCHB depends on focal lesions on the contralateral basal ganglia and subthalamic nuclei. Various conditions such as cerebrovascular, neurodegenerative, neoplastic, immunologic, infectious, and metabolic diseases are known as secondary causes of HCHB. This paper aims to compare and discuss the HCHB in various etiologies.Case Reports: Here, we reported 5 cases of HCHB induced by non-ketotic hyperosmolar hyperglycemia (NKKH), thrombotic stroke, and toxoplasmosis cerebral. We compare the admission data, clinical course, imaging, treatment, and outcome of every case.Conclusion: Various hypotheses have been proposed to explain the pathophysiology of HCHB due to these conditions. Principally, the main management for these cases is to determine the etiology and correct the underlying disorder

TRIGEMINAL NEURALGIA CAUSED BY ARTERIOVENOUS MALFORMATION OF THE POSTERIOR FOSSA : A CASE REPORT Widodo Mardi Santoso; Opik Jamaludin; Catur Ari Setianto; Neila Raisa
Journal of Pain, Headache and Vertigo Vol. 1 No. 1 (2020): March
Publisher : Journal of Pain, Headache and Vertigo

Trigeminal neuralgia (TN) is a sudden, severe, brief, stabbing, and recurrent pain within one or more branches of the trigeminal nerve. Trigeminal neuralgia has a prevalence of 0.1-0.2 per thousand and an incidence ranging from about 4-5/100,000/year up to 20/100,000/year after age 60. A 35 year old woman presented with 1 year history of right facial pain. Physical examination showed hyperalgesia and allodynia in all division of right trigeminal nerve. Magnetic resonance imaging with contrast demonstrated flow void signal in the right cerebellopontine angle. Computed tomography angiography confirmed the diagnosis of AVM (arteriovenous malformation), and demonstrated the malformed niduses were fed by the right posterior inferior cerebellar artery and the right superior cerebellar artery, and drained vein into basal vein of rosenthal, without hemorrhage or aneurysm intranidal appearance. carbamazepin 2x100 mg per oral for 7 days effectively decreased the facial pain significantly (from the numeric rating scale (NRS) score 8 to 5). Open surgical was not prefered for this patient because the AVM was small, unruptured, and located in eloquent area. Radiosurgery is considered if the medication fails. Trigeminal neuralgia with facial pain affecting all devision of nervus trigeminus with pulsatile headache can be suspected symptomatic TN. Radiological examination such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) angiography can be performed to detect the cause of TN.

CARPAL TUNNEL SYNDROME (DIAGNOSIS AND MANAGEMENT) Devi Annisa; Sri Budhi Rianawati; Masruroh Rahayu; Neila Raisa; Shahdevi Nandar Kurniawan
Journal of Pain, Headache and Vertigo Vol. 2 No. 1 (2021): March
Publisher : Journal of Pain, Headache and Vertigo

Carpal Tunnel Syndrome (CTS) is a neuropathy disease that affects the median nerve with an incidence of around 90%. Carpal Tunnel Syndrome appears in 3.8% of the general population, with the highest prevalence occurring in women. There are several risk factors associated with CTS, namely medical and non-medical factors. The mechanism of carpal tunnel syndrome until now is still very complex and is not known with certainty, but compression and traction factors in the median nerve are thought to be the most common cause of CTS. Carpal Tunnel Syndrome can manifest clinically with subjective signs such as paresthesia, proprioceptive changes, and paresis, as well as objective signs, such as changes in motor sensitivity and function, positive Tinel and Phallen tests, and thenar muscle atrophy. The diagnosis of Carpal Tunnel Syndrome is based on the classic symptoms of pain, numbness, tingling, and/or burning sensation in the distribution of the median nerve in the hand, as well as the abnormal function of the median nerve based on nerve conduction studies. Conservative therapy is an option. Especially in Carpal Tunnel Syndrome patients with mild to moderate symptoms. Conservative therapy can be given in the form of corticosteroid and physical therapy. Patients with severe CTS or whose symptoms have not improved after four to six months of conservative therapy should be considered for surgical treatment.

RELATIONSHIP BETWEEN CLINICAL FINDINGS OF CARPAL TUNNEL SYNDROME WITH ENMG AND USG WRIST RESULT Masruroh Rahayu; Shahdevi Nandar Kurniawan; Neila Raisa; Farida Widyastuti
MNJ (Malang Neurology Journal) Vol. 8 No. 2 (2022): 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.2022.008.02.12

Background: Carpal tunnel syndrome is symptomatic compression neuropathy of median nerve in carpal tunnel on wrist causes functional decreased in that area. CTS is diagnosed from clinical, physical examination, also from ENMG and USG wrist. This research aims to know about CTS characteristics and the relationship between clinical findings of CTS with ENMG and USG wrist results. Objective: This study aims to determine whether there is a relationship between the clinical findings of patients diagnosed with CTS and the results of ENMG and wrist ultrasound at the Neurology Polyclinic of Saiful Anwar Hospital, Malang. Methods: This research was descriptive observational. Data were collected from anamnesis and physical examination at Neurology Polyclinic Saiful Anwar Malang Hospital (RSSA) from April to December 2017, then examined by ENMG and USG wrist at RSSA. There are 27 patients suspected of CTS who meet inclusion and exclusion criteria. Results: From 9 months (April-December 2017) found 27 patients suspected CTS, about 19 patients (70,37%) were female and 7 patients (19,63%) were male. The majority of the age group is 25-65 years old (66,67%). Most of the occupations were housewives (48,15%). Patients most came with chief complaint of tingling (88,89%) with positive tinnel sign (77,78%), and most concomitant diseases were hypertension (48,15%). The ENMG results confirmed CTS about 92,59%, compared to the USG that confirmed CTS about 85,19%. Statistical analysis with Pearson Chi-Square test showed no relationship between clinical findings of CTS (Tinnel, Phalen, Counter Phalen, Flick test) with ENMG and USG wrist results. Conclusion: This research concluded no relationship between clinical findings of CTS with ENMG and USG wrist results.

Idiopathic Immunodeficiency in Cytomegalovirus Reactivation: A Rare Case Dewi Indiastari; Tri Wahyudi Iman Dantara; Neila Raisa
International Journal of Science and Society Vol 4 No 4 (2022): International Journal of Science and Society (IJSOC)
Publisher : GoAcademica Research & Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54783/ijsoc.v4i4.569

Idiopathic CD4 lymphocytopenia (ICL) is a rare condition characterized by an unexplained deficit of circulating CD4 T cells leading to increased risk of serious opportunistic infections. Reactivation and severe symptomatic CMV is also a rare case, except in immunocompromised patient. Patient concerns are 36-year-old male patient complained seizure, fever, cough, and dyspnea. History of chronic urticaria and prolonged Mebhydrolin consumption. HIV was negative. CD4 was low. Diagnosis in this case is Viral encephalitis, Viral pneumonitis, CMV reactivation, hemophagocytic lymphohistiocytosis immunodeficiency state. The results in this study indicate that the patients were treated with conventional therapies for Severe CMV infection with Acyclovir. Steroid was given for the last five days. The first day after administration of therapy showed clinical and laboratory improvement. Laboratory values returned to normal values on the fifth day of therapy. Since the second day after the therapy was given, the patient had no complaints. In cases of CMV reactivation, an immunodeficiency condition should be suspected. A comprehensive history, physical examination, laboratory and radiological examination, adequate therapy and and policy support are required to establish a definite diagnosis and reduce the risk of mortality.

TRIGEMINAL NEURALGIA CAUSED BY ARTERIOVENOUS MALFORMATION OF THE POSTERIOR FOSSA : A CASE REPORT Widodo Mardi Santoso; Opik Jamaludin; Catur Ari Setianto; Neila Raisa
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.2020.001.01.4

Trigeminal neuralgia (TN) is a sudden, severe, brief, stabbing, and recurrent pain within one or more branches of the trigeminal nerve. Trigeminal neuralgia has a prevalence of 0.1-0.2 per thousand and an incidence ranging from about 4-5/100,000/year up to 20/100,000/year after age 60. A 35 year old woman presented with 1 year history of right facial pain. Physical examination showed hyperalgesia and allodynia in all division of right trigeminal nerve. Magnetic resonance imaging with contrast demonstrated flow void signal in the right cerebellopontine angle. Computed tomography angiography confirmed the diagnosis of AVM (arteriovenous malformation), and demonstrated the malformed niduses were fed by the right posterior inferior cerebellar artery and the right superior cerebellar artery, and drained vein into basal vein of rosenthal, without hemorrhage or aneurysm intranidal appearance. carbamazepin 2x100 mg per oral for 7 days effectively decreased the facial pain significantly (from the numeric rating scale (NRS) score 8 to 5). Open surgical was not prefered for this patient because the AVM was small, unruptured, and located in eloquent area. Radiosurgery is considered if the medication fails. Trigeminal neuralgia with facial pain affecting all devision of nervus trigeminus with pulsatile headache can be suspected symptomatic TN. Radiological examination such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) angiography can be performed to detect the cause of TN.

CARPAL TUNNEL SYNDROME (DIAGNOSIS AND MANAGEMENT) Devi Annisa; Sri Budhi Rianawati; Masruroh Rahayu; Neila Raisa; 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.2021.002.01.2

Carpal Tunnel Syndrome (CTS) is a neuropathy disease that affects the median nerve with an incidence of around 90%. Carpal Tunnel Syndrome appears in 3.8% of the general population, with the highest prevalence occurring in women. There are several risk factors associated with CTS, namely medical and non-medical factors. The mechanism of carpal tunnel syndrome until now is still very complex and is not known with certainty, but compression and traction factors in the median nerve are thought to be the most common cause of CTS. Carpal Tunnel Syndrome can manifest clinically with subjective signs such as paresthesia, proprioceptive changes, and paresis, as well as objective signs, such as changes in motor sensitivity and function, positive Tinel and Phallen tests, and thenar muscle atrophy. The diagnosis of Carpal Tunnel Syndrome is based on the classic symptoms of pain, numbness, tingling, and/or burning sensation in the distribution of the median nerve in the hand, as well as the abnormal function of the median nerve based on nerve conduction studies. Conservative therapy is an option. Especially in Carpal Tunnel Syndrome patients with mild to moderate symptoms. Conservative therapy can be given in the form of corticosteroid and physical therapy. Patients with severe CTS or whose symptoms have not improved after four to six months of conservative therapy should be considered for surgical treatment.

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