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[Latar Belakang. Tatalaksana epilepsi bertujuan untuk mencapai keadaan bebas bangkitan tanpa efek samping obat, sehingga tercapai kualitas hidup optimal untuk penderita epilepsi. Saat ini tatalaksana farmakologis masih menjadi pilihan terapi yang banyak digunakan namun diduga sekitar 30% pasien akan resisten terhadap pengobatan. Epilepsi lobus temporal (ELT) merupakan epilepsi fokal yang paling sering resisten terhadap pengobatan. Kegagalan dalam merespons obat antiepilepsi (OAE) merupakan suatu masalah klinis penting. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang mempengaruhi epilepsi lobus temporal potensial resisten obat.Metode. Desain penelitian adalah potong lintang pada pasien ELT di Poliklinik Epilepsi RSCM. Subjek dikelompokkan menjadi potensial resisten obat dan tidak potensial resisten obat. Dilakukan wawancara dan pencatatan rekam medis mencakup usia saat onset epilepsi, frekuensi bangkitan awal, respons terhadap pengobatan pertama, etiologi epilepsi, riwayat status epileptikus, riwayat kejang demam, riwayat keluarga dengan epilepsi, gambaran CT-Scan/MRI Kepala, dan gambaran EEG.Hasil. Didapatkan 71 subjek yang memenuhi kriteria inklusi. Sebanyak 60 (84,51%) subjek potensial resisten obat. Pada analisis bivariat didapatkan hubungan bermakna antara frekuensi bangkitan awal ≥ 1x/bulan dan tidak respons terhadap pengobatan pertama dengan ELT potensial resisten obat. Pada analisis multivariat adanya riwayat status epileptikus dan tidak respons terhadap pengobatan pertama merupakan faktor yang berpengaruh secara independen terhadap ELT potensial resisten obat, sedangkan usia saat onset < 15 tahun, frekuensi bangkitan awal ≥ 1x/bulan, dan adanya riwayat kejang demam tidak secara independen berpengaruh terhadap ELT potensial resisten obat.Simpulan. Faktor yang mempengaruhi ELT potensial resisten obat adalah riwayat status epileptikus dan tidak respons terhadap pengobatan pertama sehingga perlu dievaluasi pada semua pasien ELT.;Background. The goal of management patients with epilepsy is to achieve seizure-free without medication side effects, in order to reach optimal quality of life for people with epilepsy. Currently antiepileptic drugs (AEDs) are widely used as a therapeutic option, nevertheless approximately 30% of patients are thought to be resistant to drug treatment. Temporal lobe epilepsy (TLE) is the most common type of epilepsy which is prone to be drug resistant. Failure to respond to AEDs is a problematic clinical issue. The objective of this study is to determine the factors influencing potential drug resistant temporal lobe epilepsy.Method. This was a cross sectional study involving patients with TLE in Epilepsy Clinic Cipto Mangunkusumo Hospital. Subjects were grouped into potential drug resistant and non potential drug resistant. Data obtained from interviews and medical records were age of onset, initial seizure frequency, response to the first AED, etiology of epilepsy, history of status epilepticus, history of febrile seizures, family history of epilepsy, head CT Scan/MRI features, and EEG features.Result. There were 71 eligible subjects. Potential drug resistant was found in 60 subjects (84,51%). In bivariate analysis there was a significant association between initial seizure frequency of ≥ 1x/month and no response to first AED with potential drug resistant TLE. In multivariate analysis, history of status epilepticus and no response to first AED are independent factors influencing potential drug resistant TLE, while age at onset < 15 years, initial seizure frequency ≥ 1x/month, and history of febrile seizures did not independently influence potential drug resistant TLE.Conclusion. Factors influencing potential drug resistant TLE are history of status epilepticus and no response to first AED and need to be evaluated in TLE patients., Background. The goal of management patients with epilepsy is to achieve seizure-free without medication side effects, in order to reach optimal quality of life for people with epilepsy. Currently antiepileptic drugs (AEDs) are widely used as a therapeutic option, nevertheless approximately 30% of patients are thought to be resistant to drug treatment. Temporal lobe epilepsy (TLE) is the most common type of epilepsy which is prone to be drug resistant. Failure to respond to AEDs is a problematic clinical issue. The objective of this study is to determine the factors influencing potential drug resistant temporal lobe epilepsy.Method. This was a cross sectional study involving patients with TLE in Epilepsy Clinic Cipto Mangunkusumo Hospital. Subjects were grouped into potential drug resistant and non potential drug resistant. Data obtained from interviews and medical records were age of onset, initial seizure frequency, response to the first AED, etiology of epilepsy, history of status epilepticus, history of febrile seizures, family history of epilepsy, head CT Scan/MRI features, and EEG features.Result. There were 71 eligible subjects. Potential drug resistant was found in 60 subjects (84,51%). In bivariate analysis there was a significant association between initial seizure frequency of ≥ 1x/month and no response to first AED with potential drug resistant TLE. In multivariate analysis, history of status epilepticus and no response to first AED are independent factors influencing potential drug resistant TLE, while age at onset < 15 years, initial seizure frequency ≥ 1x/month, and history of febrile seizures did not independently influence potential drug resistant TLE.Conclusion. Factors influencing potential drug resistant TLE are history of status epilepticus and no response to first AED and need to be evaluated in TLE patients.] |
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