International Journal of Integrated Health Sciences
Objective: To investigate prolonged neurological impacts of COVID-19 and establish a connection b... more Objective: To investigate prolonged neurological impacts of COVID-19 and establish a connection between initial COVID-19 symptom severity and chronic fatigue syndrome (CFS) development, poor sleep quality (PSQ), and cognitive impairment (CI) in individuals recovered from COVID-19.Methods: This cross-sectional study recruited COVID-19 survivors at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, between June and December 2021. All participants gave informed consent and underwent interviews on demography, clinical features, long-COVID questionnaire, and neurological examination. Participants underwent cognitive examination (MOCA-INA), Chalder Fatigue Scale and Pittsburgh Sleep Quality Index (PSQI) to assess CI, CFS, and PSQ variables. Chi-Square analysis was performed to determine the probability of neurological long COVID-19 syndrome manifestations using SPSS 24.0.Results: Of the 127 participants recruited, 67.7% were women, median (IQR) age of 33 (21-65) years, and time from ...
Age-related white matter lesion (WML) is considered a manifestation of sporadic cerebral small ve... more Age-related white matter lesion (WML) is considered a manifestation of sporadic cerebral small vessel disease and an important pathological substrate for dementia. Asia is notable for its large population with a looming dementia epidemic. Yet, the burden of WML and its associated risk factors across different Asian societies are unknown. Subjects from 9 Asian cities
Background: Cognitive impairment in thalassemia patients are prevalent, therefore early detection... more Background: Cognitive impairment in thalassemia patients are prevalent, therefore early detection of cognitive impairment in adult thalassemia patients is crucial for prevention. Montreal Cognitive Assessment (MoCA) is a public domain cognition screening tools that covers all cognitive domains in detecting mild cognitive impairments. Objective: To compare cognitive function between adult thalassemia patients and healty control by using Indonesia version of MoCA test (MoCA-Ina) Methods: This prospective observational analytic with case control study, compared the total scores and scores of each domain of cognition between adult thalassemia patients and healthy subjects at the
Alzheimer’s disease (AD) increasingly affects society due to aging populations. Even at pre‐clini... more Alzheimer’s disease (AD) increasingly affects society due to aging populations. Even at pre‐clinical stages, earlier and accurate diagnoses are essential for optimal AD management and improved clinical outcomes. Biomarkers such as beta‐amyloid (Aβ) or tau protein in cerebrospinal fluid (CSF) have been used as reliable markers to distinguish AD from non‐AD, and predicting clinical outcomes, to attain these goals. However, given CSF access methods’ invasiveness, these biomarkers are not used extensively in clinical settings. Blood Aβ has been proposed as an alternative biomarker since it is less invasive than CSF; however, sampling heterogeneity has limited its clinical applicability. In this review, we investigated blood Aβ as a biomarker in AD and explored how Aβ can be facilitated as a viable biomarker for successful AD management.
Introduction: Research on dementia prevalence and the potentially related risk factors from Indon... more Introduction: Research on dementia prevalence and the potentially related risk factors from Indonesia is scarce. We sought to identify the prevalence of dementia, health risk factors, and lifestyle in Jatinangor elders.Methods: A total of 686 participants completed questionnaires on lifestyle, health risk factors, and cognitive and functional tests from September 2013 to December 2013. We determined the prevalence of dementia; and the associations between health, leisure activities, dietary pattern, and dementia were analyzed using logistic regression.Results: The prevalence of dementia was 29.15%. The risk factors differed between age groups. Those aged 60–74 years and who have a lower education level, lower occupational attainment, and less active intellectual and recreational activities were associated with higher dementia risk. Those aged > 75 years living in a rural area and who take less fruit were associated with a higher risk of dementia.Conclusions: The prevalence of dem...
Background: Intracerebral haemorrhage (ICH) stroke is characterized by neurological dysfunction, ... more Background: Intracerebral haemorrhage (ICH) stroke is characterized by neurological dysfunction, caused by focal collection of blood within the brain parenchyma or ventricular system that is not caused by trauma. Hypertension is one of the main risk factors for intracerebral haemorrhage. Hypertensive crisis, which is a more severe type of uncontrolled hypertension may aggravate the cognitive outcomes. The aim of this study was to compare cognitive function between intracerebral haemorrhage stroke patients with and without hypertensive crisis. Methods: This study was a retrospective comparative analytic study, combined with a case-control study from August to November 2020. All medical records of patients with intracerebral haemorrhage, who were admitted to Dr. Hasan Sadikin General Hospital Bandung in 2019, were collected. The total score of mini-mental state examination (MMSE) which was recorded in the medical record was taken and compared between groups using the Mann-Whitney test...
Background: Pneumonia is a common complication of ischemic stroke that may worsens brain injury, ... more Background: Pneumonia is a common complication of ischemic stroke that may worsens brain injury, leading to cognitive impairment as well as patient outcome. The aim of this study was to compare cognitive function in ischemic stroke patients with and without pneumonia. Methods: This study was a comparative numerical analytic retrospective cross-sectional study that was conducted from September 2020 to February 2021. This study used data from ischemic stroke patients treated at Dr. Hasan Sadikin General Hospital in 2019 with the total sampling method. Data were stratified into patients with pneumonia and without pneumonia. The mini mental state examination (MMSE) was used to measure cognitive function in both groups and scores were compared using the Mann-Whitney Test. Results: Of the 164 data, 25 were patients with pneumonia and 139 without pneumonia. Male patients were predominantly prevalent in the pneumonia and non-pneumonia groups. Hemiparesis was the most common neurological deficit. The MMSE score was significantly lower in the pneumonia group (22.6±5.4 vs. 24.7±4.8, respectively; p-value=0.032). Conclusions: Cognitive function is more prevalent in ischemic stroke patient with pneumonia compared to non-pneumonia. However, other factors such as recurrent stroke and possible vascular risk factors should be considered for future studies to better identify the relationship between ischemic stroke and pneumonia.
Introduction: One of the most common cognitive disorders in hypertensive patients is working memo... more Introduction: One of the most common cognitive disorders in hypertensive patients is working memory. Gene polymorphisms associated with hypertension are the ReninAngiotensin System. Angiotensinogen gene known as RAS encoding associated with hypertension is RS 699. Currently, there is not much known about the difference of working memory in hypertensive patients with variant of AGT RS 699 gene compared with work memory score and polymorphism. Objective: To know the difference of working memory score in hypertension patient with AGT RS 699 gene variant by comparing the working memory score of AGT RS 699 gene polymorphism. Method:The sample of 34 people with hypertension in HasanSadikin Hypertension Hospital Polyclinic in Bandung was taken using the sampling technique of sampling. The results were analyzed by comparing the working memory score of AGT RS 699 gene polymorphism through Mini Mental State Examination (MMSE) examination, task list word, recall word list, digit span and omiss...
The impairment in the visuo constructive domain (VCD) is frequent in Alzheimer disease (AD) patie... more The impairment in the visuo constructive domain (VCD) is frequent in Alzheimer disease (AD) patients, but it has not been extensively investigated in these patients and in mild cognitive impairment (MCI). Some authors had reported
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia, 2020
FACTORS THAT INFLUENCE POSTSTROKE EPILEPSY IN DR HASAN SADIKIN HOSPITALABSTRACTIntroduction:Strok... more FACTORS THAT INFLUENCE POSTSTROKE EPILEPSY IN DR HASAN SADIKIN HOSPITALABSTRACTIntroduction:Stroke is the most commonly identified cause of epilepsy in adult. Stroke patients with cortical involvement, hemorrhagic stroke, severe neurological deficits, and old age are factors which influence the incidence of poststroke epilepsy.Aim: This research was to analyse factors which influence the incidence of poststroke epilepsy in Dr. Hasan Sadikin Hospital, Bandung.Method:The case-control study was performed retrospectively from 1725 stroke patients in dr. Hasan Sadikin Hospital Bandung during the period of January 2014-December 2016. Mann-Whitney statistical analysis, Spearman rank and logistic regression were performed to see the relationship between neurological deficits during onset of stroke, patient age, location of lesions and stroke type on poststroke epilepsy. Neurologic deficits were assessed by National Institutes of Health Stroke Scale (NIHSS), location of lesions and stroke ty...
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia, 2020
THE OCCURRENCE AND EVOLUTION OF APHASIA SYNDROME WITHIN ONE MONTH AFTER STROKEABSTRACTIntro... more THE OCCURRENCE AND EVOLUTION OF APHASIA SYNDROME WITHIN ONE MONTH AFTER STROKEABSTRACTIntroduction: Aphasia is a barrier for the rehabilitation of patients with stroke. The examination of aphasia is not only for diagnostic purpose, but also for the patient remaining language proficiency information and for comprehensive stroke treatment.Aims: To study the incidence rate of aphasia in acute ischemic stroke and the change of the aphasia syndrome one month after stroke.Methods: A descriptive observational with cohort study on ischemic stroke patients in Neurology ward, Dr. Hasan Sadikin Hospital and other hospitals in Bandung between November 2017 and February 2018. Tes Afasia, Diagnosis, Informasi dan Rehabilitasi(TADIR, a tools for diagnostic and rehabilitation of aphasia for Indonesian) was used to diagnose aphasia initially and repeated one month after diagnosis.Results: Aphasia was found in 24 out of 102 patients with acute ischemic stroke (23.5%). Majority was male (58.3%),...
Introduction: The aging process is characterized by a decrease in muscle mass and muscle strength... more Introduction: The aging process is characterized by a decrease in muscle mass and muscle strength. It causes the deterioration of handgrip muscles. Diminishing handgrip strength can impact the activities of daily life, including the maintenance of oral hygiene. A toothbrush handle must be gripped firmly enough to remove plaque. Objectives: The aim of this study was to examine handgrip muscle strength and oral hygiene skills in the elderly. Methods: This study was a correlational analysis using a cross-sectional study design with a consecutive sampling technique of the elderly. The study was conducted in the rural village of Sinartanjung, Banjar, West Java, Indonesia. Handgrip strength was measured twice using an Electronic Hand Dynamometer Camry EH 101. Oral hygiene skills were assessed using the O'Leary plaque index to measure plaque control. Data were presented in tables and as percentages. A non-parametric statistical Spearman rank test was used to measure the correlation bet...
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia, Sep 1, 2018
Neurological soft sign (NSS) adalah kelainan neurologis minor yang terutama dapat dilihat pada pe... more Neurological soft sign (NSS) adalah kelainan neurologis minor yang terutama dapat dilihat pada performa motorik dan bukan merupakan tanda adanya kelainan fokal pada otak ataupun suatu karakteristik akibat kondisi neurologis yang spesifik. 1-3 Neurological soft sign mencerminkan adanya ketidakmatangan otak yang menyebabkan gangguan koneksi antara daerah kortikal dengan subkortikal atau antar daerah kortikal yang menyebabkan gangguan fungsi otak. 1 Gejala dan tanda NSS dapat ditemukan pada anak dalam masa tumbuh kembang dan menghilang dengan bertambahnya usia seiring dengan tingkat kematangan otak. 1-4 Menetapnya NSS pada usia tertentu tidak hanya menunjukkan adanya
Background: Cognitive impairment is a common condition that may affect up to 50% of stroke patien... more Background: Cognitive impairment is a common condition that may affect up to 50% of stroke patients. Post stroke cognitive impairment is associated with reduced quality of life, which may increase the number of dependency. Recurrent stroke may happen in approximately 25% patients and they have higher rates of cognitive impairment. Objective: The aim of this study is to examine the comparison of cognitive function between first ischemic stroke and recurrent ischemic stroke patients in Hasan Sadikin Hospital, Bandung. Methods: This study is a retrospective, cross-sectional study using the data recruited between the year 2012 - 2016 at the Department of Neurology at the Hasan Sadikin Hospital Bandung. The data collected in this study were demographic data, including age, level of education, and residence, and the clinical data as well. Cognitive function was assessed using Mini-Mental State Examination (MMSE). The comparison between the cognitive function between both groups were analy...
Seizure semiology is an effective method for syndrome diagnosis, especially when electroencephalo... more Seizure semiology is an effective method for syndrome diagnosis, especially when electroencephalogram (EEG) and brain magnetic resonance imaging (MRI) cannot provide sufficient information. Diagnosis of clinical epilepsy based on semiology required a comprehensive knowledge especially for neurology residents as candidate of neurology specialist.
International Journal of Integrated Health Sciences
Objective: To investigate prolonged neurological impacts of COVID-19 and establish a connection b... more Objective: To investigate prolonged neurological impacts of COVID-19 and establish a connection between initial COVID-19 symptom severity and chronic fatigue syndrome (CFS) development, poor sleep quality (PSQ), and cognitive impairment (CI) in individuals recovered from COVID-19.Methods: This cross-sectional study recruited COVID-19 survivors at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, between June and December 2021. All participants gave informed consent and underwent interviews on demography, clinical features, long-COVID questionnaire, and neurological examination. Participants underwent cognitive examination (MOCA-INA), Chalder Fatigue Scale and Pittsburgh Sleep Quality Index (PSQI) to assess CI, CFS, and PSQ variables. Chi-Square analysis was performed to determine the probability of neurological long COVID-19 syndrome manifestations using SPSS 24.0.Results: Of the 127 participants recruited, 67.7% were women, median (IQR) age of 33 (21-65) years, and time from ...
Age-related white matter lesion (WML) is considered a manifestation of sporadic cerebral small ve... more Age-related white matter lesion (WML) is considered a manifestation of sporadic cerebral small vessel disease and an important pathological substrate for dementia. Asia is notable for its large population with a looming dementia epidemic. Yet, the burden of WML and its associated risk factors across different Asian societies are unknown. Subjects from 9 Asian cities
Background: Cognitive impairment in thalassemia patients are prevalent, therefore early detection... more Background: Cognitive impairment in thalassemia patients are prevalent, therefore early detection of cognitive impairment in adult thalassemia patients is crucial for prevention. Montreal Cognitive Assessment (MoCA) is a public domain cognition screening tools that covers all cognitive domains in detecting mild cognitive impairments. Objective: To compare cognitive function between adult thalassemia patients and healty control by using Indonesia version of MoCA test (MoCA-Ina) Methods: This prospective observational analytic with case control study, compared the total scores and scores of each domain of cognition between adult thalassemia patients and healthy subjects at the
Alzheimer’s disease (AD) increasingly affects society due to aging populations. Even at pre‐clini... more Alzheimer’s disease (AD) increasingly affects society due to aging populations. Even at pre‐clinical stages, earlier and accurate diagnoses are essential for optimal AD management and improved clinical outcomes. Biomarkers such as beta‐amyloid (Aβ) or tau protein in cerebrospinal fluid (CSF) have been used as reliable markers to distinguish AD from non‐AD, and predicting clinical outcomes, to attain these goals. However, given CSF access methods’ invasiveness, these biomarkers are not used extensively in clinical settings. Blood Aβ has been proposed as an alternative biomarker since it is less invasive than CSF; however, sampling heterogeneity has limited its clinical applicability. In this review, we investigated blood Aβ as a biomarker in AD and explored how Aβ can be facilitated as a viable biomarker for successful AD management.
Introduction: Research on dementia prevalence and the potentially related risk factors from Indon... more Introduction: Research on dementia prevalence and the potentially related risk factors from Indonesia is scarce. We sought to identify the prevalence of dementia, health risk factors, and lifestyle in Jatinangor elders.Methods: A total of 686 participants completed questionnaires on lifestyle, health risk factors, and cognitive and functional tests from September 2013 to December 2013. We determined the prevalence of dementia; and the associations between health, leisure activities, dietary pattern, and dementia were analyzed using logistic regression.Results: The prevalence of dementia was 29.15%. The risk factors differed between age groups. Those aged 60–74 years and who have a lower education level, lower occupational attainment, and less active intellectual and recreational activities were associated with higher dementia risk. Those aged > 75 years living in a rural area and who take less fruit were associated with a higher risk of dementia.Conclusions: The prevalence of dem...
Background: Intracerebral haemorrhage (ICH) stroke is characterized by neurological dysfunction, ... more Background: Intracerebral haemorrhage (ICH) stroke is characterized by neurological dysfunction, caused by focal collection of blood within the brain parenchyma or ventricular system that is not caused by trauma. Hypertension is one of the main risk factors for intracerebral haemorrhage. Hypertensive crisis, which is a more severe type of uncontrolled hypertension may aggravate the cognitive outcomes. The aim of this study was to compare cognitive function between intracerebral haemorrhage stroke patients with and without hypertensive crisis. Methods: This study was a retrospective comparative analytic study, combined with a case-control study from August to November 2020. All medical records of patients with intracerebral haemorrhage, who were admitted to Dr. Hasan Sadikin General Hospital Bandung in 2019, were collected. The total score of mini-mental state examination (MMSE) which was recorded in the medical record was taken and compared between groups using the Mann-Whitney test...
Background: Pneumonia is a common complication of ischemic stroke that may worsens brain injury, ... more Background: Pneumonia is a common complication of ischemic stroke that may worsens brain injury, leading to cognitive impairment as well as patient outcome. The aim of this study was to compare cognitive function in ischemic stroke patients with and without pneumonia. Methods: This study was a comparative numerical analytic retrospective cross-sectional study that was conducted from September 2020 to February 2021. This study used data from ischemic stroke patients treated at Dr. Hasan Sadikin General Hospital in 2019 with the total sampling method. Data were stratified into patients with pneumonia and without pneumonia. The mini mental state examination (MMSE) was used to measure cognitive function in both groups and scores were compared using the Mann-Whitney Test. Results: Of the 164 data, 25 were patients with pneumonia and 139 without pneumonia. Male patients were predominantly prevalent in the pneumonia and non-pneumonia groups. Hemiparesis was the most common neurological deficit. The MMSE score was significantly lower in the pneumonia group (22.6±5.4 vs. 24.7±4.8, respectively; p-value=0.032). Conclusions: Cognitive function is more prevalent in ischemic stroke patient with pneumonia compared to non-pneumonia. However, other factors such as recurrent stroke and possible vascular risk factors should be considered for future studies to better identify the relationship between ischemic stroke and pneumonia.
Introduction: One of the most common cognitive disorders in hypertensive patients is working memo... more Introduction: One of the most common cognitive disorders in hypertensive patients is working memory. Gene polymorphisms associated with hypertension are the ReninAngiotensin System. Angiotensinogen gene known as RAS encoding associated with hypertension is RS 699. Currently, there is not much known about the difference of working memory in hypertensive patients with variant of AGT RS 699 gene compared with work memory score and polymorphism. Objective: To know the difference of working memory score in hypertension patient with AGT RS 699 gene variant by comparing the working memory score of AGT RS 699 gene polymorphism. Method:The sample of 34 people with hypertension in HasanSadikin Hypertension Hospital Polyclinic in Bandung was taken using the sampling technique of sampling. The results were analyzed by comparing the working memory score of AGT RS 699 gene polymorphism through Mini Mental State Examination (MMSE) examination, task list word, recall word list, digit span and omiss...
The impairment in the visuo constructive domain (VCD) is frequent in Alzheimer disease (AD) patie... more The impairment in the visuo constructive domain (VCD) is frequent in Alzheimer disease (AD) patients, but it has not been extensively investigated in these patients and in mild cognitive impairment (MCI). Some authors had reported
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia, 2020
FACTORS THAT INFLUENCE POSTSTROKE EPILEPSY IN DR HASAN SADIKIN HOSPITALABSTRACTIntroduction:Strok... more FACTORS THAT INFLUENCE POSTSTROKE EPILEPSY IN DR HASAN SADIKIN HOSPITALABSTRACTIntroduction:Stroke is the most commonly identified cause of epilepsy in adult. Stroke patients with cortical involvement, hemorrhagic stroke, severe neurological deficits, and old age are factors which influence the incidence of poststroke epilepsy.Aim: This research was to analyse factors which influence the incidence of poststroke epilepsy in Dr. Hasan Sadikin Hospital, Bandung.Method:The case-control study was performed retrospectively from 1725 stroke patients in dr. Hasan Sadikin Hospital Bandung during the period of January 2014-December 2016. Mann-Whitney statistical analysis, Spearman rank and logistic regression were performed to see the relationship between neurological deficits during onset of stroke, patient age, location of lesions and stroke type on poststroke epilepsy. Neurologic deficits were assessed by National Institutes of Health Stroke Scale (NIHSS), location of lesions and stroke ty...
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia, 2020
THE OCCURRENCE AND EVOLUTION OF APHASIA SYNDROME WITHIN ONE MONTH AFTER STROKEABSTRACTIntro... more THE OCCURRENCE AND EVOLUTION OF APHASIA SYNDROME WITHIN ONE MONTH AFTER STROKEABSTRACTIntroduction: Aphasia is a barrier for the rehabilitation of patients with stroke. The examination of aphasia is not only for diagnostic purpose, but also for the patient remaining language proficiency information and for comprehensive stroke treatment.Aims: To study the incidence rate of aphasia in acute ischemic stroke and the change of the aphasia syndrome one month after stroke.Methods: A descriptive observational with cohort study on ischemic stroke patients in Neurology ward, Dr. Hasan Sadikin Hospital and other hospitals in Bandung between November 2017 and February 2018. Tes Afasia, Diagnosis, Informasi dan Rehabilitasi(TADIR, a tools for diagnostic and rehabilitation of aphasia for Indonesian) was used to diagnose aphasia initially and repeated one month after diagnosis.Results: Aphasia was found in 24 out of 102 patients with acute ischemic stroke (23.5%). Majority was male (58.3%),...
Introduction: The aging process is characterized by a decrease in muscle mass and muscle strength... more Introduction: The aging process is characterized by a decrease in muscle mass and muscle strength. It causes the deterioration of handgrip muscles. Diminishing handgrip strength can impact the activities of daily life, including the maintenance of oral hygiene. A toothbrush handle must be gripped firmly enough to remove plaque. Objectives: The aim of this study was to examine handgrip muscle strength and oral hygiene skills in the elderly. Methods: This study was a correlational analysis using a cross-sectional study design with a consecutive sampling technique of the elderly. The study was conducted in the rural village of Sinartanjung, Banjar, West Java, Indonesia. Handgrip strength was measured twice using an Electronic Hand Dynamometer Camry EH 101. Oral hygiene skills were assessed using the O'Leary plaque index to measure plaque control. Data were presented in tables and as percentages. A non-parametric statistical Spearman rank test was used to measure the correlation bet...
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia, Sep 1, 2018
Neurological soft sign (NSS) adalah kelainan neurologis minor yang terutama dapat dilihat pada pe... more Neurological soft sign (NSS) adalah kelainan neurologis minor yang terutama dapat dilihat pada performa motorik dan bukan merupakan tanda adanya kelainan fokal pada otak ataupun suatu karakteristik akibat kondisi neurologis yang spesifik. 1-3 Neurological soft sign mencerminkan adanya ketidakmatangan otak yang menyebabkan gangguan koneksi antara daerah kortikal dengan subkortikal atau antar daerah kortikal yang menyebabkan gangguan fungsi otak. 1 Gejala dan tanda NSS dapat ditemukan pada anak dalam masa tumbuh kembang dan menghilang dengan bertambahnya usia seiring dengan tingkat kematangan otak. 1-4 Menetapnya NSS pada usia tertentu tidak hanya menunjukkan adanya
Background: Cognitive impairment is a common condition that may affect up to 50% of stroke patien... more Background: Cognitive impairment is a common condition that may affect up to 50% of stroke patients. Post stroke cognitive impairment is associated with reduced quality of life, which may increase the number of dependency. Recurrent stroke may happen in approximately 25% patients and they have higher rates of cognitive impairment. Objective: The aim of this study is to examine the comparison of cognitive function between first ischemic stroke and recurrent ischemic stroke patients in Hasan Sadikin Hospital, Bandung. Methods: This study is a retrospective, cross-sectional study using the data recruited between the year 2012 - 2016 at the Department of Neurology at the Hasan Sadikin Hospital Bandung. The data collected in this study were demographic data, including age, level of education, and residence, and the clinical data as well. Cognitive function was assessed using Mini-Mental State Examination (MMSE). The comparison between the cognitive function between both groups were analy...
Seizure semiology is an effective method for syndrome diagnosis, especially when electroencephalo... more Seizure semiology is an effective method for syndrome diagnosis, especially when electroencephalogram (EEG) and brain magnetic resonance imaging (MRI) cannot provide sufficient information. Diagnosis of clinical epilepsy based on semiology required a comprehensive knowledge especially for neurology residents as candidate of neurology specialist.
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