Dialysis Disequilibrium Syndrome (DDS) is a set of neurological signs and symptoms that can occur during or following dialysis. Osmotic fluid gradient alteration caused by the dialysis process can cause cerebral edema. This process relates to the changes of high gradient urea in both the blood and central nervous system (CNS), which can modulate extracellular fluid influx into brain cells. A 77-year-old woman presented with chronic kidney disease (CKD) and hypertension with headache and tonic-clonic seizure following initial hemodialysis. In this case, we identified that adjustment to the hemodialysis prescriptions such as duration, blood flow rate, and target reduction of blood urea would be the key to avoid seizure following hemodialysis.

Latar Belakang: Coronavirus Disease 2019 (COVID-19) yang disebabkan oleh virus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) merupakan penyakit yang mudah menular dan menyebabkan kondisi pandemi saat ini. Manifestasi utama infeksi SARS-CoV-2 adalah gangguan sistem respirasi, tetapi manifestasi neurologis telah dilaporkan pada beberapa literatur. Tujuan: Untuk menggambarkan manifestasi klinis neurologis yang dapat ditemukan pada pasien COVID-19. Diskusi: Gejala neurologis yang dapat timbul pada COVID-19 bervariasi dari nyeri kepala, dizziness, anosmia, penyakit serebrovaskular, penurunan kesadaran, ensefalitis, meningitis, Guillain-Barré Syndrome, dan gangguan muskuloskeletal. Manifestasi klinis neurologis terkadang muncul mendahului gejala tipikal COVID-19. Simpulan: COVID-19 menyebabkan manifestasi klinis neurologis yang bervariasi dari gejala non-spesifik hingga gejala spesifik yang melibatkan sistem saraf pusat, sistem saraf tepi, dan muskuloskeletal. Infeksi virus ini perlu diwaspadai sebagai penyebab keluhan neurologis di masa pandemi dan manifestasi neurologis baru perlu diantisipasi selama perawatan pasien COVID-19. Kata Kunci: COVID-19, manifestasi neurologis, SARS-CoV-2

Background: Corona virus disease 2019 (COVID-19) is a pandemic disease with a wide spectrum of symptoms.  Neurological symptoms are often found in this disease. Stroke on the other hand is a multifactorial disease that can be caused by a lot of underlying problems. Case: We report a case of a 67 years old man with a weakness on the right side that was worsened one day before arrival in hospital and a shortness of breath. the patient had history of stroke before, and controlled hypertension. Head Ct-scan showed a stroke infarct, and Swab RT-PCR showed + SARS-CoV-2. Discussion: Infection may become the risk factor of stroke. inflammatory mediators such as TNF-a , and CRP  support the procoagulant state which leads to stroke. Conclusion: COVID-19 may increase the risk of stroke due to the inflammation state that leads to procoagulant state

Vestibular symptoms are symptoms that interfere with daily activities. Diagnosing these symptoms often relies on radiologic examinations that lead to a false negative. Proper clinical approach and study showed higher accuracy than radiologic examination on vestibular disease. These clinical approaches are based on time, triggers, and targeted analysis. The new vestibular symptoms will be classified into acute vestibular syndrome, episodic vestibular syndrome, and chronic vestibular syndrome. An acute vestibular syndrome is a vestibular symptom that lasts for days up to weeks. The episodic vestibular syndrome is vestibular symptoms that periodically appear. The chronic vestibular syndrome is a vestibular symptom that appears from months to years. Diagnosing vestibular symptoms must be precisely made. The proper termination is the best way to facilitate doctors in communicating with each other. Using this classification is a precise and easy way to detect vestibular etiology.  This review is made for clinicians to determine and differentiate the etiology of the vestibular syndrome and gives information in uniforming nomenclature of vestibular symptoms.

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