Page 346 - Abstract Book KONIKA 18

Neurology

P-NEU-019
A 13-year-old Girl with Multiple Sclerosis, Obesity, and Vitamin D Deficiency:
A Case Report

Karima Iffani Ulifah, Nugroho Danu Tri Subroto, Melinda
Department of Pediatrics, Saiful Anwar Hospital, Faculty of Medicine, Universitas Brawijaya,
Malang, East Java, Indonesia

Abstract
Background Multiple Sclerosis (MS) is an autoimmune disease of the central nervous system that affects
approximately 2.3 million people worldwide. The increasing prevalence of obesity has the potential to
contribute to an increase in the rate of multiple sclerosis in children. Objective To demonstrate response
of cyclophosphamide and high-dose methylprednisolone in multiple sclerosis patient. Case We have been
reported a case of multiple sclerosis with obesity and vitamin D deficiency in a thirteen-year-old girl who
came to the emergency room with the chief complaint paralysis in her right upper extremity and lower
extremity. From the past medical history, this patient was hospitalized 1 year before because weakness of
left lower extremity, then the patient improved after being given oral steroids. Neurological examination
revealed motor impairment on the right side of the upper and lower extremities, absent pathological reflexes,
and normal cranial nerves. The Magnetic Resonance Imaging (MRI) results is multiple white matter
lesions in the left frontoparietal lobe, left centrum semi ovale, left corona radiata, left anterior posterior
periventricular horn et causa ADEM (Acute Disseminated Encephalomyelitis), and chronic multiple
infarcts. The management of these patient is second-line treatment of multiple sclerosis (cyclophosphamide
and high-dose methylprednisolone), physiotherapy, calorie deficit diet, and vitamin D supplementation.
Conlusion After the patient received therapy for six months, the patient was able to walk again, move her
hands, weight loss, and higher levels of vitamin D.
Keywords: multiple sclerosis; obesity; vitamin D deficiency

P-NEU-020
COVID-19 Infections among Hospitalized Children
with Neurological Manifestations in a Tertiary Referral Hospital

Kristy Iskandar , Yunika P. Dewi , Nurhuda H. Setyawan , Alexandra W. S. Pangarso ,
3
1
1
2
Agung Triono , Elisabeth S. Herini 1
1
2
1
Department of Child Health , Department of Clinical Pathology , and
Department of Radiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada/
Dr. Sardjito Hospital, Yogyakarta, Central Java, Indonesia
Abstract
Background Neurological symptoms could be the manifestation of COVID-19. However, not all children
hospitalized with neurological manifestation were tested with COVID-19, especially in those without
respiratory symptoms. Moreover, COVID-19 data in neurological manifestation in Indonesia are still
lacking. Objective To report COVID-19 infection in children hospitalized with neurological manifestations.
Methods Patients <18 years hospitalized with neurological symptoms in Dr. Sardjito Hospital between
February-July 2021 were included. COVID-19 infection was confirmed by RT-PCR tests with nasopharyngeal
swab and/or serologic testing. Clinical and laboratory data were retrieved. Results Of 58 children, 32 (55%)
were male patients with mean age 6.4±5.7 years. Twenty-one (36.2%) patients were SARS-CoV-2 confirmed.
Among confirmed patients, 9 were previously healthy children, while 7 (33.3%) patients had underlying
neurological disorders, 4 had other comorbidities. 62% of confirmed patients did not have respiratory
symptoms. In the COVID-19 group, diagnoses included encephalitis (n=9), ventriculitis=1, peripheral
neuropathy (n=2), stroke (n=3), epilepsy (n=2), and cytomegalovirus (n=1), Guillain Barre syndrome (n=1).
RT-PCR of SARS-CoV-2 were negative from the 4 patients whose cerebrospinal was tested. Mortality rates
of COVID-19 and nonCOVID-19 patients were 23.8% and 8.1%, respectively (OR 3.5 [95%CI 0.75 to 16.7],
P=0.23). Conclusion Children hospitalized with neurological symptoms might have COVID-19 infection
and tend to have higher mortality. Our findings highlight the importance of SARS-CoV-2 screening in all
children with neurological disorders, particularly in the absence of respiratory symptoms.
Keywords: SARS-CoV-2; COVID-19; neurological symptoms; pediatric patient

298 KONIKA XVIII Abstract Book