This survey was performed to determine the availability of epilepsy surgery, and understand the limiting factors to epilepsy surgery in ASEAN countries with total of 640 million population. Method: A cross-sectional survey was completed by national representatives in all ASEAN countries (Brunei,

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Managing epilepsy in the elderly remains complicated largely due to factors related to aging. In this population, management practices are increasingly shifting towards the use of newer-generation anti-seizure medications (ASMs) as they are generally associated with better tolerability and safety profiles than older ones. Perampanel is a new ASM with broad-spectrum efficacy and a favorable safety profile. However, because of the lack of information and experience in its use, the prescription of perampanel has not been optimized in the elderly in the real-world setting in Asia. A group of epilepsy experts across the region convened at a series of virtual meetings to share their experience and discuss recommendations on perampanel use in elderly patients, including dose optimization, considerations with treatment initiation, and strategies to manage adverse events and maximize tolerability. This article summarizes key clinical and real-world evidence for perampanel in the elderly and consolidates the experts’ opinions on optimizing perampanel use in elderly Asian patients with epilepsy, providing practical guidance for clinicians to address challenges related to treatment initiation and tolerance.

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Early detection of Sensory Processing Disorder (SPD) is important for deciding on appropriate interventions for children at risk. However, there is no valid screening tool available at this moment. The purpose of this study was to validate the deGangi, Sensorimotor History Questionnaire for Preschooler (SHQP), and neurological soft sign of Cambridge Neurological Inventory (NSS CNI) against intelligent quotient (IQ) to establish a reliable cutoff for SPD screening tools for children aged 4-6 years. Sixty-four parent-child were recruited randomly from 3 kindergartens in Bandung, Indonesia. Eligible parents were asked to fill out the SHQP, while their child was assessed using theWechsler Preschool and Primary Scale of Intelligent (WPPSI) and NSS CNI. The deGangi SHQP score and NSS CNI showed a weak and moderate correlation with Full-scale IQ (FIQ). The total score of deGangi SHQP's sensitivity was 50% with a specificity of 53.4% and a negative predictive value (NPV) of 91.2% agaisnt the FIQ score. The total sensitivity for the NSS CNI was 66.7%, while the total specificity was 58.6% and the NPV was 94.4%. Meanwhile, the sensitivity for the sensory integration subscale score of the NSS CNI was 83.3%, with a specificity of 60.3% and an NPV of 97.2%. The deGangi SHQP can be considered to be an SPD screening tool with the cut-off scores for each subscale of self-regulation, sensory processing of touch, sensory processing of movement, emotional maturity, and motor maturity of 3, 3, 3, and 2, respectively, while the NSS CNI can be used for identifying SPD in children aged 4-6 years with a cut-off scores for the motor coordination, sensory integration, and disinhibition subscales of 7, 10, and 3, respectively.

Risk Factors of Pneumonia in Acute Stroke at Hasan Sadikin Hospital Bandung Abstract Background and Objective:Pneumonia is the most common non neurological complications in acute stroke (22%) that increase mortality rate, length of stay and hospitalization cost. It is necessary to identified risk factors for pneumonia including neurogenic pulmonary edema (NPE) for better prevention and early intervention. The purpose of this study is to determine risk factors of pneumonia (including NPE) in acute stroke patients at Hasan Sadikin General Hospital Bandung. Subject and Methods: Prospective observational descriptive study, consecutive sampling method, during September – October 2019. Primary data collected from acute stroke patients such as stroke severity, type, location and size of stroke, treatment during hospitalizataion, comorbidities (including NPE). Pneumonia was diagnosed based on Central for Disease Control Prevention (CDC) criteria, NPE based on Davison criteria. Results: 30 patients (28.3%) with pneumonia in acute stroke patients. Pneumonia were commonly found in NGT insertion (90%), dysphagia (64,71%), total anterior circulation infarct (TACI) (61,54%), large infarct size (61,54%), GCS 9-12 (50%) and NIHSS 16-20 (50%). NPE only found in 6,60% acute stroke patients, 57,14% of them developed pneumonia. Conclusions: Pneumonia in acute stroke patients is more often found in NGT insertion, dysphagia, TACI location, large infarct size, lower GCS and more severe stroke degree.

Latar Belakang dan Tujuan: Status epileptikus merupakan kasus emergensi neurologis dengan mortalitas 57%, 63% merupakan status epileptikus non-konvulsivus (SENK). Diagnosis SENK tidak mudah karena pasien tidak menunjukkan bangkitan yang jelas sehingga diperlukan pemeriksaan elektroensefalografi (EEG). Penyakit serebrovaskular, infeksi susunan saraf pusat (SSP), tumor otak, penyakit autoimmun, dan gangguan metabolik dapat mengakibatkan SENK selain itu dapat memiliki gambaran klinis menyerupai SENK. Tujuan penelitian untuk melihat faktor-faktor yang berperan pada diagnosis SENK. Subjek dan Metode: Penelitian observasional analitik potong lintang retrospektif pada 132 pasien dengan diagnosis klinis SENK di RSUP dr. Hasan Sadikin Bandung selama periode Juli 2017 – Juni 2020. Hasil: Dari 132 subjek dengan diagnosis klinis SENK, hanya 100 pasien yang memenuhi kriteria inklusi. Pemeriksaan EEG dilakukan pada semua pasien, sebagian besar dalam waktu < 24 jam (82,4 – 87,9%), hanya 34 pasien yang terkonfirmasi sebagai SENK. Gangguan metabolik secara signifikan berperan pada SENK sebesar 29,4% (p=0,049). Pada pasien yang tidak terkonfirmasi SENK, penurunan kesadaran diakibatkan gangguan metabolik. Smpulan: Gangguan metabolik berperan pada kejadian SENK. Pasien dengan diagnosis klinis SENK memerlukan pemeriksaan EEG segera untuk menghindari diagnosis berlebihan