Skelrosis multipel pada pria Bali: laporan kasus

I Putu Eka Kusmadana; Wandy Margo; Gede Suputra

doi:10.15562/ism.v14i1.1625

Skelrosis multipel pada pria Bali: laporan kasus

I Putu Eka Kusmadana ,

Wandy Margo ,

Gede Suputra ,

pdf |
DOI: https://doi.org/10.15562/ism.v14i1.1625 |
Published: 2023-04-01

Abstract

Introduction: Multiple Sclerosis (MS) is a chronic autoimmune disorder of the central nervous system characterized by lesions that predominantly attack the brain, optic nerves and spinal cord. The incidence of MS in Asia and Oceania is rare, but with the evolution of diagnostic modalities, the incidence of MS is increasing.

Case Presentation: This is a case report of multiple sclerosis; A 42-year-old Balinese male patient presenting with being unable to walk since 3 months ago as the chief complaint accompanied by tingling, a blurred eye and dripping urine. During the last ten years these complaints lasted for several months but improved on their own without treatment. The physical examination showed visual loss, paraparesis, sensory disturbances, cerebellar ataxia, and urinary incontinence. The patient underwent an MRI and showed lesions suggestive of MS. The patient was diagnosed as MS and treated with methyl-prednisolone 3x16 mg for 3 month and was referred to a medical rehabilitation unit. After one month of treatment, the patient's condition getting better.

Conclusion: This case report provides a deeper understanding of MS as an autoimmune disease of the central nervous system that is rarely found and often misdiagnosed in primary health care, so that knowledge regarding early diagnosis and early management of MS patients should be widely known to prevent worsening of the condition and suppress recurrence rates.

Pendahuluan: Sklerosis multipel (multiple sclerosis/MS) merupakan kelainan autoimun kronis pada sistem saraf pusat yang ditandai dengan lesi-lesi yang predominan menyerang otak, nervus optikus dan medula spinalis. Kejadian MS di benua Asia dan Oseania diketahui jarang ditemukan, namun seiring terjadinya evolusi modalitas diagnostik insiden MS makin tahun ditemukan semakin meningkat.

Laporan Kasus: Laporan kasus ini mengenai sklerosis multipel; Pasien laki-laki 42 tahun, suku bali, datang dengan tidak bisa berjalan sejak 3 bulan yang lalu sebagai keluhan utama, disertai dengan kesemutan pada tangan dan kaki kiri, mata kanan kabur dan urin menetes. Selama sepuluh tahun terakhir keluhan-keluhan tersebut hilang timbul, berlangsung dan menetap selama beberapa bulan namun membaik dengan sendirinya tanpa pengobatan. Hasil pemeriksaan fisik menunjukkan visual loss mata kanan, paraparese, gangguan sensorik, ataksia serebelar, serta inkotinensia urin. Pasien dilakukan MRI dan hasil menunjukkan lesi sugestif MS. Pasien ditegakkan sebagai MS dan diterapi menggunakan metil-prednisolon 3x16 mg selama 3 bulan dan dikonsulkan ke unit rehabilitasi medis. Pasca satu bulan pengobatan, keluhan-keluhan pasien dikatakan membaik.

Conclusion: Laporan kasus ini memberikan pemahanan lebih mendalam mengenai MS sebagai suatu penyakit autoimun pada sistem saraf pusat yang jarang ditemukan dan kerap terjadi misdiagnosis di layanan kersehatan primer, sehingga pengetahuan mengenai diagnosis awal dan tatalaksana awal pada pasien MS sebaiknya diketahui secara luas untuk mecegah perburukan kondisi dan menekan angka kekambuhan.

References

Stenager E. A global perspective on the burden of multiple sclerosis. Lancet Neurol. 2019;18(3):227–8.
Joseph JP. Diagnosis of multiple sclerosis. Mult Scler. 2019;
Daroff RB, Aminoff MJ. Encyclopedia of the neurological sciences. Academic press; 2014.
McGinley MP, Goldschmidt CH, Rae-Grant AD. Diagnosis and treatment of multiple sclerosis: a review. Jama. 2021;325(8):765–79.
Wallin MT, Culpepper WJ, Campbell JD, Nelson LM, Langer-Gould A, Marrie RA, et al. The prevalence of MS in the United States: a population-based estimate using health claims data. Neurology. 2019;92(10):e1029--e1040.
Ascherio A, Munger KL. Epidemiology of multiple sclerosis: from risk factors to prevention—an update. In: Seminars in neurology. 2016. p. 103–14.
Forouhari A, Taheri G, Salari M, Moosazadeh M, Etemadifar M. Multiple sclerosis epidemiology in Asia and Oceania; A systematic review and meta-analysis. Mult Scler Relat Disord. 2021;54:103119.
Larassati H, Estiasari R, Yunus RE, Parizel PM. State-of-the-Art Review: Demyelinating Diseases in Indonesia. Mult Scler Int. 2021;2021.
Hauser SL, Goodin DS. Multiple sclerosis and other demyelinating diseases. In: Fauci AS, editor. Harrison’s Neurology in Clinical Medicine,. 3rd ed. McGraw-Hill; 2013. p. 435–50.
Damasceno A, Von Glehn F, Brandão CO, Damasceno BP, Cendes F. Prognostic indicators for long-term disability in multiple sclerosis patients. J Neurol Sci. 2013;324(1–2):29–33.
Ribbons KA, McElduff P, Boz C, Trojano M, Izquierdo G, Duquette P, et al. Male sex is independently associated with faster disability accumulation in relapse-onset MS but not in primary progressive MS. PLoS One. 2015;10(6):e0122686.
Rosso M, Chitnis T. Association between cigarette smoking and multiple sclerosis: a review. JAMA Neurol. 2020;77(2):245–53.
PERDOSSI. Pedoman Diagnosis dan Tata Laksana Multipel Sklerosis di Indonesia. Badan Penerbit Fak Univ Indones. 2016;1–33.
Rolfes L, Pfeuffer S, Ruck T, Melzer N, Pawlitzki M, Heming M, et al. Therapeutic apheresis in acute relapsing multiple sclerosis: current evidence and unmet needs—A systematic review. J Clin Med. 2019;8(10):1623.
Widyadharma IP, Satyarsa AB, Sanjaya F, Gitari NM, Niryana IW, Purwata TE, Jawi IM, Suprapta DN, Sudewi AR. Potential Of Anthocyanin Based Poly (Methyl Methacrylate) Nanoparticles Specific Activated Microglia In Management Inflammatory Pain On Herniated Nucleus Pulposus: A Literature Review. MNJ (Malang Neurology Journal). 2021;7(1):40-7.
Suryo JC. Sklerosis Multipel: Diagnosis dan Tatalaksana. Cermin Dunia Kedokt. 2021;48(8):296–303.

[1] Stenager E. A global perspective on the burden of multiple sclerosis. Lancet Neurol. 2019;18(3):227–8.

[2] Joseph JP. Diagnosis of multiple sclerosis. Mult Scler. 2019;

[3] Daroff RB, Aminoff MJ. Encyclopedia of the neurological sciences. Academic press; 2014.

[4] McGinley MP, Goldschmidt CH, Rae-Grant AD. Diagnosis and treatment of multiple sclerosis: a review. Jama. 2021;325(8):765–79.

[5] Wallin MT, Culpepper WJ, Campbell JD, Nelson LM, Langer-Gould A, Marrie RA, et al. The prevalence of MS in the United States: a population-based estimate using health claims data. Neurology. 2019;92(10):e1029--e1040.

[6] Ascherio A, Munger KL. Epidemiology of multiple sclerosis: from risk factors to prevention—an update. In: Seminars in neurology. 2016. p. 103–14.

[7] Forouhari A, Taheri G, Salari M, Moosazadeh M, Etemadifar M. Multiple sclerosis epidemiology in Asia and Oceania; A systematic review and meta-analysis. Mult Scler Relat Disord. 2021;54:103119.

[8] Larassati H, Estiasari R, Yunus RE, Parizel PM. State-of-the-Art Review: Demyelinating Diseases in Indonesia. Mult Scler Int. 2021;2021.

[9] Hauser SL, Goodin DS. Multiple sclerosis and other demyelinating diseases. In: Fauci AS, editor. Harrison’s Neurology in Clinical Medicine,. 3rd ed. McGraw-Hill; 2013. p. 435–50.

[10] Damasceno A, Von Glehn F, Brandão CO, Damasceno BP, Cendes F. Prognostic indicators for long-term disability in multiple sclerosis patients. J Neurol Sci. 2013;324(1–2):29–33.

[11] Ribbons KA, McElduff P, Boz C, Trojano M, Izquierdo G, Duquette P, et al. Male sex is independently associated with faster disability accumulation in relapse-onset MS but not in primary progressive MS. PLoS One. 2015;10(6):e0122686.

[12] Rosso M, Chitnis T. Association between cigarette smoking and multiple sclerosis: a review. JAMA Neurol. 2020;77(2):245–53.

[13] PERDOSSI. Pedoman Diagnosis dan Tata Laksana Multipel Sklerosis di Indonesia. Badan Penerbit Fak Univ Indones. 2016;1–33.

[14] Rolfes L, Pfeuffer S, Ruck T, Melzer N, Pawlitzki M, Heming M, et al. Therapeutic apheresis in acute relapsing multiple sclerosis: current evidence and unmet needs—A systematic review. J Clin Med. 2019;8(10):1623.

[15] Widyadharma IP, Satyarsa AB, Sanjaya F, Gitari NM, Niryana IW, Purwata TE, Jawi IM, Suprapta DN, Sudewi AR. Potential Of Anthocyanin Based Poly (Methyl Methacrylate) Nanoparticles Specific Activated Microglia In Management Inflammatory Pain On Herniated Nucleus Pulposus: A Literature Review. MNJ (Malang Neurology Journal). 2021;7(1):40-7.

[16] Suryo JC. Sklerosis Multipel: Diagnosis dan Tatalaksana. Cermin Dunia Kedokt. 2021;48(8):296–303.

Skelrosis multipel pada pria Bali: laporan kasus

Abstract

References

How to Cite

Search Panel