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Herbowo Agung F. Soetomenggolo
Long qt syndrome pada pasien dengan keluhan kejang = Long qt syndrome in patients with symptom of seizure
"[ABSTRAK
Latar belakang Long QT syndrome LQTS adalah gangguan irama jantung bergejala kejang yang harus dikenali sejak dini karena dapat menyebabkan kematian mendadak Tujuan Mengetahui angka kejadian LQTS pada pasien dengan keluhan kejang serta karakteristiknya Metode Studi potong lintang terhadap anak yang pernah mengalami kejang tanpa provokasi di poliklinik neurologi anak RSUPN Cipto Mangunkusumo Subyek berusia 6 bulan hingga 17 tahun Panjang QT interval diukur menggunakan EKG dan dinilai menggunakan metode Bazzet Hasil Seratus empat puluh enam pasien kejang mengikuti penelitian ini Usia subyek jenis kelamin serta jenis kejang memiliki sebaran cukup merata Pada penelitian ini didapatkan kelainan penyerta kejang seperti tuli sensorineural autisme keterlambatan perkembangan menyeluruh disabilitas intelektual dan sindroma Rett Sebanyak 20 6 mengalami epilepsi intraktabel Tidak ditemukan subyek dengan pencetus kejang aktivitas fisik dan stres emosional dan hanya 2 7 memiliki riwayat keluarga meninggal mendadak Hasil penilaian QTc pada seluruh subyek di bawah 0 44 detik Nilai QTc terpendek adalah 0 333 detik dan nilai QTc terpanjang adalah 0 437 Nilai tersebut masih dalam rentang normal QTc pada anak Simpulan Pada penelitian ini tidak didapatkan pemanjangan QTc baik pada penderita kejang umum maupun fokal ABSTRACT Background Long QT syndrome LQTS is a heart rhythm disorder with symptom of seizures that should be identified early because it can cause sudden death Aim Knowing the prevalence of LQTS in patients with symptom of seizures and characteristics Method A cross sectional study of children who have experienced an unprovoked seizure in child neurology clinic Cipto Mangunkusumo Subjects aged 6 months to 17 years QT interval was measured by ECG and assessed with Bazzet rsquo s formula Results One hundred and forty six patients with seizures were followed in this study The age sex and seizure rsquo s type of subject distributed evenly In this study we found some disorder along with seizure such as sensorineural deafness autism global developmental delay intellectual disability and Rett syndrome A total of 20 6 had intractable epilepsy We didn rsquo t find subject with physical activity and emotional stress as the trigger of seizure and only 2 7 had a family history of sudden death QTc assessment results in all subjects were under 0 44 seconds The shortest QTc values was 0 333 seconds and the longest QTc value was 0 437 seconds This value is still within the normal range QTc in children Conclusion In this study we concluded that we found no QTc prolongation in patients with seizures ; Background Long QT syndrome LQTS is a heart rhythm disorder with symptom of seizures that should be identified early because it can cause sudden death Aim Knowing the prevalence of LQTS in patients with symptom of seizures and characteristics Method A cross sectional study of children who have experienced an unprovoked seizure in child neurology clinic Cipto Mangunkusumo Subjects aged 6 months to 17 years QT interval was measured by ECG and assessed with Bazzet rsquo s formula Results One hundred and forty six patients with seizures were followed in this study The age sex and seizure rsquo s type of subject distributed evenly In this study we found some disorder along with seizure such as sensorineural deafness autism global developmental delay intellectual disability and Rett syndrome A total of 20 6 had intractable epilepsy We didn rsquo t find subject with physical activity and emotional stress as the trigger of seizure and only 2 7 had a family history of sudden death QTc assessment results in all subjects were under 0 44 seconds The shortest QTc values was 0 333 seconds and the longest QTc value was 0 437 seconds This value is still within the normal range QTc in children Conclusion In this study we concluded that we found no QTc prolongation in patients with seizures , Background Long QT syndrome LQTS is a heart rhythm disorder with symptom of seizures that should be identified early because it can cause sudden death Aim Knowing the prevalence of LQTS in patients with symptom of seizures and characteristics Method A cross sectional study of children who have experienced an unprovoked seizure in child neurology clinic Cipto Mangunkusumo Subjects aged 6 months to 17 years QT interval was measured by ECG and assessed with Bazzet rsquo s formula Results One hundred and forty six patients with seizures were followed in this study The age sex and seizure rsquo s type of subject distributed evenly In this study we found some disorder along with seizure such as sensorineural deafness autism global developmental delay intellectual disability and Rett syndrome A total of 20 6 had intractable epilepsy We didn rsquo t find subject with physical activity and emotional stress as the trigger of seizure and only 2 7 had a family history of sudden death QTc assessment results in all subjects were under 0 44 seconds The shortest QTc values was 0 333 seconds and the longest QTc value was 0 437 seconds This value is still within the normal range QTc in children Conclusion In this study we concluded that we found no QTc prolongation in patients with seizures ]"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Siregar, Ira Aliza
Efektivitas Pemberian Dosis Awal Fenobarbital Intravena untuk Anak Pasca- Kejang dan Faktor - Faktor yang Memengaruhinya = Effectiveness of Initial Intravenous Phenobarbital in Post-Seizure Child and The Risk Factors of Recurrence
"

Latar Belakang: Kejang berulang berisiko mengganggu kualitas hidup anak dan dapat berkembang menjadi status epileptikus. Sampai saat ini belum ada rekomendasi tatalaksana pasca kejang pada anak untuk mencegah kejang berulang.

Tujuan: Menilai efektivitas fenobarbital intravena pada anak pasca kejang untuk mencegah kejang berulang serta faktor risiko yang memengaruhinya.
Metode: Studi observasional kohort prospektif pada 70 subjek sesuai kriteria inklusi. Status epileptikus dan pemberian fenitoin atau fenobarbital intravena sebelumnya dieksklusi. Pada seluruh subjek diberikan fenobarbital 10 mg/kgbb dan dipantau selama 2x24 jam untuk melihat adanya kejang berulang. Faktor risiko yang diteliti adalah etiologi kejang, usia awitan, frekuensi kejang, lama kejang, perkembangan motorik kasar, interval antara kejang dan pemberian fenobarbital, perkembangan neurologi pasca fenobarbital, kadar leukosit dan pemeriksaan EEG.
Hasil: Sebanyak 70 dari 79 pasien yang dianalisis, proporsi terbesar laki – laki (61%) dan berusia <3 tahun (46%). Sebanyak 77% subjek tidak mengalami kejang berulang setelah pemberian fenobarbital 10 mg/kgbb. Usia awitan kejang >3 tahun (OR 4,444; p=0,046) dan perkembangan motorik kasar (OR 3,932; IK95% 1,072 – 14,422; p=0,039) merupakan faktor risiko independen terhadap terjadinya kejang berulang.
Kesimpulan: Efektivitas pemberian dosis awal fenobarbital untuk mencegah terjadinya kejang berulang sebesar 77,1%. Usia awitan kejang >3 tahun dan keterlambatan perkembangan motorik kasar merupakan faktor risiko kejang berulang.

Background: Recurrent seizures are associated with poor quality of life of child and at risk of developing into status epilepticus. In Indonesia, there is no recommendation for management post-seizure in child to prevent recurrent seizure.

Aims: To assess the effectiveness of initial intravenous phenobarbital in post-seizure child to prevent recurrence of seizure and identify the risk factors.
Method: A prospective cohort observational study of 70 subjects according inclusion criteria. Patients with status epilepticus or administration of intravenous phenytoin or phenobarbital previously were excluded. All subject were given 10 mg/kgbb intravenous phenobarbital and evalute seizure recurrence for 2x24 hours. The risk factors studied were seizure etiology, onset age of seizure, seizure duration, gross motor development, intervals between seizures and phenobarbital administration, neuological development, leucocyte levels and electroencephalography examination.
Results: A total of 70 from 79 subject were analyzed, found that the largest proportion were male (61%) and aged <3 years (46%). A total of 77% subjects did not had recurrence of seizure in 2x24 hours monitoring after administration of 10 mg/kgbb intravenous phenobarbital. Onset age of seziure >3 years (OR 4.444; p=0.046) and gross motor development (OR 3.932; 95%CI 1.072 – 14.422; p=0.039) were independent risk factors for seizure recurrence.
Conclusion: The administration of 10 mg/kgbb intravenous phenobarbital was effective in preventing seizure recurrence. Onset age of seizures >3 years and delayed gross motor development are the risk factors for seizure recurrence.

"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library