CATATAN PINGGIR ABS

FEBRILE CONVULSION

FEVER

CONVULSION

(- ) (+)

EPILEPSY NONEPILEPSY

=SOL=METABOLIC=etc

INFECTION

INTRA OR EXTRACRANIAL

SEIZURE( CONVULSION )

PAROXYSMAL INVOLUNTARY DISTURBANCE OF BRAIN FUNCTION

=IMPAIRMENT OR LOSS OF CONSCIOUSNESS=ABNORMAL MOTOR ACTIVITY=SENSORY DISTURBANCE OR=AUTONOMIC DYSFUNCTION

MANIFEST AS

EPILEPSY

RECURRENT SEIZURES

FEVER (-)ACUTE CEREBRAL INSULT (-)

EPILEPSY

LOSS OF CONSCIOUSNESS

( + ) ( - )

GENERALIZED PARTIAL UNCLASSIFIED

PARTIAL EPILEPSY

ALTERED OF CONSCIOUSNESS

(-)

SIMPLE

(+)

COMPLEX

MOTOR ACTIVITY IS THE MOST COMMON SYMPTOMS

DD : TICS Can be briefly supressed

=SP FOLLOWED BY IMPAIRED CONSCIOUSNESS=CONSCIOUSNESS IMPAIRED AT ONSET

GENERALIZED EPILEPSY

ABSENCE(PETITMAL)

SUDDEN CESSATION OF MOTOR ACTIVITY

TONIC CLONIC MYOCLONICINFANTILE SPASM

= 4 – 8 months=brief symmetric contractions of the neck ,trunk and extremities

STATUS EPILEPTICUS

A continous convulssion lasting greter 30 min orthe occurence of serial convulsions between which there isthere is no return of consciousnes

SERANGAN KEJANG

DEMAM

FEBRILE CONVULSION ( KEJANG DEMAM)

PROSES EKSTRAKRANIAL

LP

INTRAKRANIAL

1. KEJANG /TWITCHING TIDAK TAHU SEBABNYA2. UUB MENONJOL3. KESADARAN MENURUN4. KELAINAN NEUROLOGIS (PARALISIS/PARESIS a STRABISMUS)5. TBC MILIAR6. KAKU KUDUK DENGAN KESADARAN MENURUN7. LEUKEMIA8. FEVER OF UNKNOWN ORIGIN / PROLONGED FEVER

INDIKASI LP

FEBRILE CONVULSION

SIMPLE COMPLEX( EPILEPSY TRIGGERED OFF BY FEVER )

PENGOBATAN KEJANG SECEPAT MUNGKIN

PENGOBATAN KEJANG SECEPAT MUNGKIN

PROFILAKSISINTERMITTENT

PROFILAKSIS JANGKA PANJANG

2 THN BEBAS KEJANG

LIVINGSTON

Dosis muatan-Fenobarbital=15-20 mg/kgbb- Fenitoin = 15-20 mg/kgbb( max=200 mg)

Rumatan-Fenobarbital=5-6 mg/kgbb/hari-Fenitoin = 8-10 mg/kgbb/hari

Contoh

Anak 2 thn dengan kejang BB = 15 kg

= Dosis muatan : 1. Fenobarbital (Sibital @ ) : 15 x (15-20) = ± 250 mg 1 ampul Sibital 200 mg /2 ml 250 mg =2,5 ml + 22,5 ml NaCl 0,9 % ( encerkan ≥ 5 x ) 1 ml = 10 mg Kecepatan pemberian 1-2 mg/kgbb/menit 15- 30 mg/menit 2 ml/menit

2. Fenitoin ( Dilantin @ ) : 15 x ( 15-20 ) = ± 250 mg 1 ampul Dilantin 100 mg/2ml 250 mg =5 ml + 20 ml Na Cl 0,9 % (encerkan ≥ 5 x ) 1 ml = 10 mg Kecepatan pemberian 1-2 mg/kgbb/menit 15-30 mg/menit 2 ml /menit

= Dosis rumatan : i.v atau oral hitung sendiri

SIMPLE FEBRILE CONVULSION MENURUT LIVINGSTON

1. Umur 6 bln - 6 tahun2. Kejang tidak lebih 15 menit3. Kejang umum4. Kejang timbul dalam 16 jam pertama setelah timbul demam5. Sebelum dan sesudah kejang tidak ada kelainan neurologi6. Kejang tidak lebih 4 x setahun7. Pemeriksaan EEG satu minggu setelah demam turun normal