Attitudes toward epilepsy in Indonesia.

BACKGROUND: Indonesia is the largest island country in the world with diverse ethnicity and cultural backgrounds. This study aimed to understand the variation in attitudes toward epilepsy among the Javanese, Sundanese, and the Minahasa ethnic groups in Indonesia. METHOD: This study recruited Sundanese from Tasikmalaya and Minahasan from Manado using the Indonesian Public Attitudes Toward Epilepsy (PATE) scale. The results were compared to the Javanese and Malaysian data in previous studies. RESULT: A total of 200 respondents, 100 from each ethnic group were recruited, with a mean age of 38.51 years. They were predominantly females (54%) and had secondary education level or lower (56.67%). The Javanese had a higher total mean score, indicating poorer attitudes toward epilepsy, as compared to the Minahasan and Sundanese groups. These differences were noted in the personal domain, but not the general domain. There were no significant differences in the mean scores in both personal and general domains between the Minahasan, Sundanese, and Malaysian populations. Subanalysis on the aspects of life showed that the Javanese had a significantly higher score in the aspects of education, marital relationship, and employment. CONCLUSION: The attitudes toward epilepsy were similar between the Indonesian (Sundanese and the Minahasan) and Malaysian, except the Javanese with poorer attitude. These differences could be socioeconomically or culturally related.

A randomized study camparing oral versus injection triamcinolone in carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy found in clinical practice. Corticosteroids are effective in treating CTS. The purpose of this study was to evaluate the effi cacy of oral versus local injection of triamcinolone in relieving symptoms and improving neurophysiological parameters in CTS. This is a randomized controlled trial performed at Hasan Sadikin Hospital, Bandung. Inclusion criteria were idiopathic CTS patients without thenar atrophy and no contraindications to corticosteroids. Subjects were divided into oral or injection groups. The oral group was given 16 mg triamcinolone daily for 2 weeks followed by 8 mg daily for the next 2 weeks and local placebo injection. The injection group was given 15 mg local injection triamcinolone and oral placebo. The outcome was assessed using Global Symptom Score and nerve conduction studies. Fifty subjects were randomized to oral or injection group. The injection group show signifi cant improvement at 2 and 4 weeks while the oral group showed signifi cant improvement only at 2 weeks. Comparing both groups, improvement in neurophysiological parameters were signifi cantly greater in the injection group. In conclusion, local injection triamcinolone show better neurophysiologic outcome and effi cacy in relieving symptoms compared to oral triamcinolone in CTS.

The need for epilepsy surgery services in Indonesia

Background and Objective: Early surgical intervention in appropriately screened patients is likely to improve overall quality of life and reduce costs to the patient and community. But, surgical treatment for epilepsy remains underutilized in Indonesia. The purpose of this study is to determine whether there are candidates for epilepsy surgery in Indonesia. Methods: The study was performed in Hasan Sadikin and St. Borromew Hospitals, Bandung, West Java, Indonesia. Medical records of patients with epilepsy from year 2005 at Hasan Sadikin Hospital, and data of patient with epilepsy or seizures who had brain MR imaging at the Radiology Department, St. Borromew Hospital between 2000 and 2005 were retrospectively analysed. Results: From the total of 118,314 new patients visiting out-patient clinic in 2005, 253 (0.21%) had epilepsy. Epilepsy is the second most common disease encountered in neurology outpatient clinic after stroke. Brain MR imaging from 139 seizure and epileptic patients showed abnormalities in 73 (52.5%), which were hippocampal sclerosis, hippocampal atrophy or hypertrophy, hippocampal cyst or gliosis, temporal lobe atrophy and hemiatrophy. Conclusion: There were significant proportion of epilepsy patients who were possible candidates for surgical treatment in Bandung, Indonesia. There is urgent need for development of epilepsy surgery service in Indonesia.