PRESENTASI KASUS KEJANG DEMAM KOMPLEKS
Disusun oleh
ABDUL CHARIS KONORAS 20090!020"
Pe#$i#$in%& '() Juli*ni S+)A
KEPANITERAAN KLINIK ILMU KESEHAT KES EHATAN AN ANAK ANAK PROGRAM PENDIDIKAN PRO,ESI DOKTER ,AKULT ,AKULTAS KEDOKTERAN KED OKTERAN DAN ILMU KESEHATAN KESEHATAN UNI-ERSITAS MUHAMMADI.AH .OG.AKARTA .OG.AKARTA RSUD MUNTILAN 20!/
2
HALAMAN PENGESAHAN
Tel*h 'iseu1ui '*n 'is*h*n3 +(esen*si *sus 'en%*n 1u'ul KEJANG DEMAM KOMPLEKS
Disusun oleh & N*#* & A$'ul A$'ul Ch*(is Ch*(is Kono(* Kono(*ss No) M*h*sis4* & 20090!020"
Tel*h 'i+(esen*si*n H*(i5T*n%%*l& Ju#6*3 !! A+(il 20!/
Dis*h*n oleh&
Dosen Pembimbing,
'( Juli*ni S+A
3
HALAMAN PENGESAHAN
Tel*h 'iseu1ui '*n 'is*h*n3 +(esen*si *sus 'en%*n 1u'ul KEJANG DEMAM KOMPLEKS
Disusun oleh & N*#* & A$'ul A$'ul Ch*(is Ch*(is Kono(* Kono(*ss No) M*h*sis4* & 20090!020"
Tel*h 'i+(esen*si*n H*(i5T*n%%*l& Ju#6*3 !! A+(il 20!/
Dis*h*n oleh&
Dosen Pembimbing,
'( Juli*ni S+A
3
DA,TAR ISI HALAMAN JUDUL...................................... JUDUL............................................................. .................................................... ............................. .....ii
HALAMAN PENGESAHAN............................ PENGESAHAN................................................... ................................................... ............................ .iii DAFTAR DAFTAR ISI........................................... ISI.................................................................. .............................................. ......................................... ..................iv iv BAB I STAT STATUS PASIEN................. PASIEN........................................ .............................................. ................................................. .......................... A. I!en"i"#s... I!en"i"#s........ .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ......... ......... .......... .......... .......... .............. ............. .... B. An#mnesis... An#mnesis........ .......... .......... ......... ......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ............ .............. ....... $. Peme%i&s##n Peme%i&s##n Fisi&..... Fisi&.......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ............ ................ .................2 ........2 D. !i#gnosis.......................................... !i#gnosis................................................................. .............................................. .......................................3 ................3 E.
'en#"#(#&s#n# 'en#"#(#&s#n##n.. #n....... .......... .......... ......... ......... .......... .......... .......... .......... .......... .......... .......... ............ ................. .................... ..............3 ....3
F.
Fo((o) Fo((o) *'....... *'............ .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .............. .................. ................+ .......+
BAB II TINJAUAN PUSTAA...... PUSTAA............................. .............................................. ...........................................................................A. Deinisi........................ Deinisi............................................... .............................................. .............................................. .................................................B. Insi!ensi... Insi!ensi........ .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .............. .................. ...............$. F#&"o% F#&"o% Resi&o.... Resi&o......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ............... ........................D. E"io(ogi....................................... E"io(ogi.............................................................. .............................................. ............................................/ ...................../ E.
P#"oisio(og P#"oisio(ogi..... i.......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ............ ................. ................0 ......0
F.
(#sii&#si.. (#sii&#si....... ......... ......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... ........... ................ ................... ............1 ...1
G. Ge#(# (inis..... (inis.......... .......... .......... .......... ......... ......... .......... .......... .......... .......... .......... .......... ............ ................ ................... ...............1 .....1 H. Di#gnosis......................................... Di#gnosis................................................................ .............................................. ..................................... .............. I.
Di#gnosis Di#gnosis B#n!ing.. B#n!ing....... .......... .......... .......... ......... ......... .......... .......... .......... .......... .......... .......... .......... ............ ................. .............2 ...2
J.
Pen#"#(#&s#n Pen#"#(#&s#n##n... ##n........ .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .......... .............. .................. .............2 ....2
. P%ognosis.. P%ognosis....... .......... .......... .......... .......... .......... .......... .......... ......... ......... .......... .......... .......... .......... .......... .......... .......... .......... ............... ........../ / BAB III ESIMPULAN................................ ESIMPULAN....................................................... .............................................. ................................. .......... BAB I4 DAFTAR DAFTAR PUSTAA................... PUSTAA.......................................... .................................................... ............................. .......2
+
BAB I STATUS PASIEN
A) I'eni*s
5 5 5 5 5 5
N#m# 6 An MFA Um*% 6 "#7*n T#ngg#( L#7i% 6 3 M#%e" 21+ Jenis e(#min 6 L#&i5(#&i A(#m#" 6 e%"en, $#n!i%eo M#s*& Rs 6 1 A'%i( 21+ 89.21:
B) An*#nesis *) Keluh*n U*#*
e#ng, Dem#m $) RPS
P#sien !#"#ng me(#(*i IGD !eng#n &e(*7#n !em#m "#!i '#gi SMRS, Dem#m n#i& 'e%(#7#n, "e%*s mene%*s, !ise%"#i !eng#n &e#ng so%e 7#%i SMRS, ; - meni", < SMRS, !i#)#(i !eng#n "#ng#n !#n &#&i sebe(#7 &#n#n, &em*!i#n sem*# "*b*7 &e#ng be%7en"i sen!i%i se"e(#7 m#s*& IGD, &em*!i#n &e#ng &#(i !i RS, R) e#ng "#n'# !em#m 85:, B#"*& 85:, Pi(e& 8=: 3 HSMRS, m#&#n>min*m 8=:, BA>BAB 8=: se'e%"i Bi#s#. R) 'e%&emb#ng#n 6 #(#n !eng#n B#n"*#n 85:, Me%#ng&#& 8=:, &#"#8=: 7) RPD
R) e#ng Dem#m8=: b*(#n #n*#%i 21+, se!#ng meng&ons*msi ob#" 4#('%o#" A?i!, J#"*7 8=:, $i!e%# e'#(# 85:, R) &e#ng "#n'# !em#m 85:, As7m# 85:, e(#in#n J#n"*ng 85: o
Ri)#@#" e(#7i%#n6 BBL$, $B, SM, SPT !eng#n Asi&si# se!#ng
2
C) Pe#e(is**n ,isi *) -i*l Si%n
e#!##n Um*m
6 Se!#ng
N#!i
6 /1 <>m
RR
6 ++ <>m
S*7*
6 30,- o$
S'2
6 9/ 82 N 2 ('m:
es#!#%#n6 A'#"is
$) Ke+*l*
No%mo?e'7#( L& +-,- ?m, $A 5>5, SI 5>5, P*'i( Iso&o%
ɵ
3 > 3 mm, %e(e&
$#7#@# =>=, 7) Lehe(
Pembes#%#n Lnn 85:, #&* *!*& 85:, B%*!Cins&i 85: ') Pe#e(is**n Tho(*8
Sime"%is 8=:, Re"%#&si 85:, 4esi&*(e% =>=, %on&7i 5>5, 7eeCing 5>5, S "*ngg#(, S2 s'(i" "#& &ons"#n, Bising 85: e) Pe#e(is**n A$'o#en
S*'e(, Bising *s*s =, Pe%is"#("i& N, m#ss# #bno%m#( 5, NT , MT 85: )
Es(e#i*s
A&%#( 7#ng#" 8=:, $RT 2 !e"i&, B#bins&i =>5, Hemi'(#gi !e<"%#,
3
C) Pe#e(is**n L*$o(*o(iu# A) D*(*h Ruin
HB
6 1,0
AL
6 2,-9
HMT 6 3, AE
6 +,30
AT
6 +-
B) Hiun% Jenis
Ne*"%oi(
6 2,/
L@m'7osi"
6 9,9
Monosi"
6 /,
Eosinoi(
6 1,/
B#soi(
6 1,
C) Ele(oli
N#
3-,0 mmo(>(
+,10 mmo(>(
$(
1/,0 mmo(>(
D) 'i*%nosis 5 e#ng Dem#m om'(e&s 5 bs Feb%is H s*s' B#?"e%i#( Ine?"ion
+
E) +en**l*s*n**n o
Moni"o% U, TT4, &e#ng, S'2
o
2 N 2 ('m
o
I4FD D- NS m#in"en#n?e 2 "'m mi&%o
o
P#%#?e"#mo( s%@' ?"7 "i#' +5/ #m &>' !em#m
o
Am'i?i((in !osis In"%#?%#ni#( 2115+11 mg !ib#gi + !osis +<-11 mg
o
Di#Ce'#m 1,35 1,- m(>&gbb>&#(i -m( bi(# &e#ng
o
As 4#('%o#" S@%' 21 mg>gbb>7#%i 2< 2 mg
o
$T S?#n e'#(# !eng#n &on"%#s
,) ,ollo4 u+
T#ngg#
S
A
U #'#"is
D
P
( 1>1>+
e#ng
822.1
(#n*"
)ib:
Fo&#( &e#ng
*m*m, ;- meni",
HR 01&'m RR +/ &'m T 30 o$
5 Di#Ce'#m
I4
3mg I4 5 P7ob#%bi"#( Lo#!ing 21
!ose
mg>&g
1mg
iv
se(#m#
31
meni" 5 M#in"en#n?e +mg>&gbb>7#%i 2<21mg iv
-
/
BAB II TINJAUAN PUSTAKA A) Deinisi
e#ng !em#m #!#(#7 b#ng&i"#n &e#ng @#ng "e%#!i &#%en# &en#i&#n s*7* "*b*7 8s*7* %e?"#( !i#"#s 3 $: @#ng !iseb#b&#n o(e7 s*#"* '%oses e&s"%#&%#ni*m. B) Insi'ensi
Insi!en "e%#!in@# &e#ng !em#m "e%*"#m# '#!# go(ong#n #n#& *m*% / b*(#n s#m'#i + "#7*n. H#m'i% 3 !#%i #n#& @#ng be%*m*% !i b#)#7 - "#7*n 'e%n#7 men!e%i"# &e#ng !em#m. e#ng !em#m (ebi7 se%ing !i!#'#"&#n '#!# (#&i5(#&i !#%i'#!# 'e%em'*#n. H#( "e%seb*" !iseb#b&#n &#%en# '#!# )#ni"# !i!#'#"&#n m#"*%#si se%eb%#( @#ng (ebi7 ?e'#" !ib#n!ing&#n (#&i5(#& $. ,*o( Resio F#&"o% %esi&o 'e%"#m# @#ng 'en"ing '#!# &e#ng !em#m #!#(#7 !em#m. Se(#in i"* *g# "e%!#'#" #&"o% %i)#@#" &e#ng !em#m '#!# o%#ng "*# #"#* s#*!#%# &#n!*ng, 'e%&emb#ng#n "e%(#mb#", '%ob(em '#!# m#s# neon#"*s, #n#& !#(#m 'eng#)#s#n &7*s*s, !#n &#!#% n#"%i*m %en!#7. Se"e(#7 &e#ng !em#m 'e%"#m#, &i%#5&i%# 33 #n#& #&#n meng#(#mi s#"* &#(i %e&*%ensi #"#* (ebi7, !#n &i%#5&i%# 9 #n#& meng#(#mi 3 &#(i %e&*%ensi #"#* (ebi7. Resi&o %e&*%ensi mening&#" '#!# *si# !ini, ?e'#"n@# #n#& men!#'#" &e#ng se"e(#7 !em#m "imb*(, "em'e%#"*%e @#ng s#ng#" %en!#7 s##" &e#ng, %i)#@#" &e(*#%g# &e#ng !em#m, !#n %i)#@#" &e(*#%g# e'i(e's@.
D*# '*(*7 s#m'#i 2- 'en!e%i"# &e#ng !em#m mem'*n@#i &e(*#%g# !e&#" 8o%#ng5"*# !#n s#*!#%# &#n!*ng: @#ng *g# 'e%n#7 men!e%i"# &e#ng !em#m.Ts*boi men!#'#"&#n b#7)# insi!en &e#ng !em#m '#!# o%#ng "*# 'en!e%i"# &e#ng !em#m i#(#7 0 !#n '#!# s#*!#%# &#n!*ngn@# 22.De(#'#n5
0
'*(*7 'e%sen !#%i &emb#% monosigo" !eng#n &e#ng !em#m #!#(#7 &on&o%!#ns *n"*& &e#ng !em#m.eb#n@#&#n 'ene(i"i men!#'#" &es#n b#7)# &e#ng !em#m !i"*%*n&#n se?#%# !omin#n !eng#n 'ene"%#si @#ng meng*%#ng !#n e&s'%esi @#ng be%v#%i#si, #"#* me(#(*i mo!*s 'o(igeni&.
P#!# 'en!e%i"# &e#ng !em#m %isi&o s#*!#%# &#n!*ng be%i&*"n@# *n"*& men!#'#" &e#ng !em#m i#(#7 1. N#m*n bi(# s#"* !#%i o%#ng5"*#n@# !#n s#"* s#*!#%# 'e%n#7 '*(# meng#(#mi D, &em*ng&in#n ini mening&#" men#!i -1 .
Pene(i"i#n P%o.D%.!%.S.M.L*mb#n"obing *g# mem'e%o(e7 !#"# %i)#@#" &e(*#%g# '#!# 23 'en!e%i"# D D#%i me%e&# ini /1 'en!e%i"# me%*'#&#n #n#& "*ngg#( )#&"* !i'e%i&s#.Se!#ng 22 'en!e%i"# (#inn@# 5 @#ng mem'*n@#i s#"* #"#* (ebi7 s#*!#%# &#n!*ng 5 09 'en!e%i"# 83/: mem'*n@#i s#"* #"#* (ebi7 s#*!#%# &#n!*ng @#ng 'em#7 meng#(#mi &e#ng @#ng !ise%"#i !em#m. J*m(#7 se(*%*7 s#*!#%# &#n!*ng !#%i 22 'en!e%i"# ini i#(#7 2 o%#ng, !#n 9 8+,0: !i #n"#%#n@# 'e%n#7 meng#(#mi &e#ng @#ng !ise%"#i !em#m. D. Eiolo%i E"io(ogi &e#ng !em#m s#m'#i s##" ini be(*m !i&e"#7*i, #&#n "e"#'i *m*% #n#&, "inggi !#n ?e'#"n@# s*7* mening&#" mem'eng#%*7i "e%#!in@# &e#ng. F#&"o% 7e%e!i"#s *g# mem'*n@#i 'e%#n @#i"* 522 #n#& @#ng meng#(#mi &e#ng !em#m mem'*n@#i o%#ng "*# !eng#n %i)#@#" &e#ng !em#m '#s# m#s# &e?i(n@#. 8:89:
Sem*# enis ine&si be%s*mbe% !i (*#% s*s*n#n s#%# '*s#" @#ng menimb*(&#n !em#m !#'#" men@eb#b&#n &e#ng !em#m. Pen@#&i" @#ng '#(ing se%ing menimb*(&#n &e#ng !em#m #!#(#7 ine&si s#(*%#n 'e%n##s#n #"#s "e%*"#m# "onsi((i"is !#n #%ingi"is, o"i"is me!i# #&*"8?#i%#n "e(ing# @#ng "i!#& sege%# !ibe%si7&#n #&#n me%embes &e s#%# !i &e'#(# '#!# o"#& #&#n men@eb#b&#n &e#ng !em#m:, g#s"%oen"e%i"is #&*", e<#n"em# s*bi"*m !#n ine&si
s#(*%#n &emi7. Se(#in i"*, im*nis#si DPT 8'e%"*sis: !#n ?#m'#& 8mo%bi(i: *g# !#'#" men@eb#b&#n &e#ng !em#m.
A!# bebe%#'# #&"o% @#ng m*ng&in be%'e%#n !#(#m men@eb#b&#n &e#ng !em#m,@#i"*6
. Dem#mn@# sen!i%i
2. Ee& '%o!*& "o&si& !#%i'#!# mi&%oo%g#nisme 8&*m#n !#n vi%*s: "e%7#!#' o"#&
3. Res'on #(e%gi& #"#* &e#!##n im*n @#ng #bno%m#( o(e7 ine&si
+. Pe%*b#7#n &eseimb#ng#n ?#i%#n #"#* e(e&"%o(i"
-. Ense#(i"is vi%#( 8%#!#ng o"#& #&ib#" vi%*s: @#ng %ing#n #"#* @#ng "i!#& !i&e"#7*i #"#* ense#(o'#"i "o&si& se'in"#s
Pe%n#7 !i(#'o%&#n b#7)# ine&si "e%"en"* (ebi7 se%ing !i5se%"#i D !#%i'#!# ine&si (#inn@#. Se&i"#% +, 5 +- 'en!e%i"# g#s"%oen"e%i"is o(e7 &*m#n S7ige((# meng#i#mi D !ib#n!ing g#s"%oen"e%i"is oie7 &*m#n 'en@eb#b (#inn@# !i m#n# #ng&# &e#!i#n D 7#n@# se&i"#% , "inggin@# #ng&# &e#!i#n D '#!# s7ige((osis !#n s#(mone((osis m*ng&in be%&#i"#n !eng#n ee& "o&si& #&ib#" %#?*n @#ng !i7#si(&#n &*m#n be%s#ng&*"#n. E. P*oisiolo%i Mes&i'*n me&#nisme '#s"i "e%#!in@# &e#ng "i!#& !i&e"#7*i, bebe%#'# #&"o% isio(ogis !i#ngg#' be%"#ngg*ng #)#b #"#s be%&emb#ngn@# s*#"* &e#ng.
9
Un"*& mem'e%"#7#n&#n 7i!*' se( #"#* o%g#n o"#&, !i'e%(*&#n s*#"* ene%gi @#ng !i!#'#" !#%i me"#bo(isme. B#7#n b#&* *n"*& meme"#bo(isme o"#& @#ng "e%'en"ing #!#(#7 g(*&os#. Si#" '%oses i"* #!#(#7 o&si!#si !im#n# o&sigen !ise!i#&#n !eng#n 'e%#n"#%##n *ngsi '#%*5'#%* !#n !i"e%*s&#n &e o"#& me(#(*i sis"em &#%!iov#s&*(e%. J#!i s*mbe% ene%gi o"#& #!#(#7 g(*&os# @#ng me(#(*i '%oses o&si!#si !i'e?#7 men#!i $2 !#n #i%.
Se( !i&e(i(ingi o(e7 s*#"* memb%#n @#ng "e%!i%i !#%i 'e%m*&##n !#(#m #!#(#7 (i'i! !#n 'e%m*&##n (*#% #!#(#7 ioni&. D#(#m &e#!##n no%m#( memb%#n se( ne*%on !#'#" !i(#(*i !eng#n m*!#7 o(e7 ion &#(i*m 8=: !#n s#ng#" s*(i" !i(#(*i o(e7 ion n#"%i*m 8N#=: !#n e(e&"%o(i" (#inn@#, &e?*#(i ion &(o%i!# 8$(5:. A&ib#"n@# &osen"%#si = !#(#m se( ne*%on "inggi !#n &onsen"%#si N#= men#!i %en!#7 se!#ng&#n !i (*#% se( ne*%on "e%#!i &e#!##n seb#(i&n@#.#%en# 'e%be!##n enis !#n &onsen"%#si ion !i !#(#m !#n !i (*#% se(, m#&# "e%!#'#" 'e%be!##n 'o"ensi#( @#ng !iseb*" 'o"ensi#( memb%#n !#%i se( ne*%on.Un"*& men#g# &eseimb#ng#n 'e"ensi#( memb%#n ini !i'e%(*&#n ene%gi !#n b#n"*#n enCim N#55 ATP#se @#ng "e%!#'#" '#!# 'e%m*&##n se(.
eseimb#ng#n 'e"ensi#( memb%#n ini !#'#" !i*b#7 o(e7 #!#n@#6
. Pe%*b#7#n &onsen"%#si ion !i%*#ng e&s"%#se(*(e%.
2. R#ngs#ng#n @#ng !#"#ngn@# men!#!#&, mis#(n@# me&#nis, &imi#)i #"#* #(i%#n (is"%i& !#%i se&i"#%n@#.
3. Pe%*b#7#n !#%i '#"oisio(ogi !#%i memb%#n sen!i%i &#%en# 'en@#&i" #"#* &e"*%*n#n.
P#!# &e#!##n !em#m, &en#i&#n $ #&#n meng#&ib#"&#n &en#i&#n me"#bo(isme b#s#( 15- !#n &eb*"*7#n o&sigen #&#n mening&#" s#m'#i 21. J#!i '#!# &en#i&#n s*7* "*b*7 "e%"en"* !#'#" "e%#!i 'e%*b#7#n &eseimb#ng#n !#%i memb%#n se( ne*%on, !#n !#(#m )#&"* @#ng sing&#" !#'#" "e%#!i !i*si ion
1
&#(i*m (is"%i&.Le'#s m*#"#n (is"%i& ini !emi&i#n bes#%n@# se7ingg# !#'#" me(*#s &e se(*%*7 se( m#*'*n &e memb%#n "e"#ngg#n@# !eng#n b#n"*#n b#7#n @#ng !iseb*" ne*%o"%#nsmi""e% !#n "e%#!i(#7 &e#ng.Ti#' #n#& mem'*n@#i #mb#ng &e#ng @#ng be%be!# !#n "e%g#n"*ng !#%i "inggi %en!#7n@# #mb#ng &e#ng seo%#ng #n#& men!e%i"# &e#ng '#!# &en#i&#n s*7* "*b*7 "e%"en"*. P#!# #n#& !eng#n #mb#ng &e#ng @#ng %en!#7, &e#ng s*!#7 !#'#" "e%#!i '#!# s*7* 3$, se!#ng&#n '#!# #n#& !eng#n #mb#ng &e#ng @#ng "inggi, &e#ng b#%* !#'#" "e%#!i '#!# s*7* +1$ #"#* (ebi7.
P#!# &e#ng @#ng be%(#ngs*ng (#m# bi#s#n@# !ise%"#i "e%#!in@# #'ne#, mening&#"n@# &eb*"*7#n o&sigen !#n ene%gi *n"*& &on"%#&si o"o" s&e(e" se!#ng&#n o"o" 'e%n##s#n "i!#& eisiense7ingg# "i!#& sem'#" be%n##s @#ng #&7i%n@#
"e%#!i
7i'o&semi#,
7i'e%&#'ne#,
7i'og(i&emi#,
(#&"#"
#si!osis
!iseb#b&#n me"#bo(isme #n#e%ob, 7i'o"ensi #%"en#( !ise%"#i !en@*"#n"*ng@#ng "i!#& "e%#"*% !#n s*7* "*b*7 @#ng sem#&in mening&#" o(e7 &#%en# mening&#"n@# #&"ivi"#s o"o" !#n se(#n*"n@# men@eb#b&#n me"#bo(isme o"o" mening&#". Peningkatan Suhu Tubuh F#&"o% "e%'en"ing #!#(#7 g#ngg*#n 'e%e!#%#n !#%#7 meng#&ib#"&#n 7i'o&si# se7ingg# meninggi&#n 'e%me#bi(i"#s &#'i(e% !#n "imb*( oe!em o"#& @#ng Metabolisme Basal Meningkat Resiko Tinggi Gangguan Kebutuhan Nutrisi meng#&ib#"&#n &e%*s#&#n se( ne*%on.
D#%i &en@#"##n ini !#'#" !isim'*(&#n b#7)# be%*(#ngn@# &e#ng !em#m (ebi7 O2 se%ing "e%#!i '#!# #mb#ng &e#ng @#ng %en!#7 se7ingg# !i !#(#m ke Otak Menurun 'en#ngg*(#ng#nn@# 'e%(* !i'e%7#"i&#n '#!# "ing&#" s*7* be%#'# 'en!e%i"# men#!i &e#ng. Kejang Demam TIK Meningkat Be%i&*" me%*'#&#n s&em# 'ene(#s#n &e#ng !em#m6
Kejang Demam Sederhana Kejang Demam Komleks
Resiko Injur%
Gangguan Perkusi !aringan
De"sit #olume$airan
ResikoTinggiGangguan TumbuhKembang
F. Kl*sii*si Um*mn@# &e#ng !em#m !i&(#sii&#si&#n men#!i 2 go(ong#n @#i"* &e#ng !em#m se!e%7#n#, @#ng be%(#ngs*ng &*%#ng !#%i - meni" !#n
2
be%(#ngs*ng *m*m, !#n &e#ng !em#m &om'(e&s, @#ng be%(#ngs*ng &*%#ng !#%i - meni", o&#(, #"#* m*("i'(e 8(ebi7 !#%i &#(i &e#ng !#(#m 2+ #m:. %i"e%i# 'enggo(ong#n "e%seb*" !i&em*&#n o(e7 be%b#g#i '#&#%. D#(#m 7#( ini "e%!#'#" bebe%#'# 'e%be!##n &e?i( !#(#m 'enggo(ong#n "e%seb*", men@#ng&*" enis &e#ng, "inggin@# !em#m, *si# 'en!e%i"#, (#m#n@# &e#ng be%(#ngs*ng, g#mb#%#n %e&#m o"#& !#n (#inn@#.
e#ng !em#m se!e%7#n# 87#%*s memen*7i sem*# &%i"e%i# be%i&*":
5 Be%(#ngs*ng sing&#"
5 Um*mn@# se%#ng#n be%7en"i sen!i%i !#(#m )#&"* - meni"
5 B#ng&i"#n &e#ng "oni&, "oni&5&(oni& "#n'# ge%#&#n o&#(
5 Ti!#& be%*(#ng !#(#m )#&"* 2+ #m
e#ng !em#m &om'(e&s 87#n@# !eng#n s#(#7 s#"* &%i"e%i# be%i&*":
5 e#ng be%(#ngs*ng (#m#, (ebi7 !#%i - meni"
5 e#ng o&#( #"#* '#%si#( s#"* sisi, #"#* &e#ng *m*m !i!#7*(*i !eng#n &e#ng '#%si#(
5 e#ng be%*(#ng 2 &#(i #"#* (ebi7 !#(#m 2+ #m, #n#& s#!#% &emb#(i !i #n"#%# b#ng&i"#n &e#ng
G. Ge1*l* Klinis A!# 2 ben"*& &e#ng !em#m (menurut Liingstone:, @#i"*6
3
. e#ng !em#m se!e%7#n# 8Sim'(e Feb%i(e SeiC*%e:, !eng#n ?i%i5?i%i ge#(# &(inis seb#g#i be%i&*" 6
•
e#ng be%(#ngs*ng sing&#", - meni"
•
e#ng *m*m "oni& !#n #"#* &(oni&
•
Um*mn@# be%7en"i sen!i%i
•
T#n'# ge%#&#n o&#( #"#* be%*(#ng !#(#m 2+ #m
2. e#ng !em#m &om'(i&#"# 8$om'(e< Feb%i(e SeiC*%e:, !eng#n ?i%i5?i%i ge#(# &(inis seb#g#i be%i&*" 6
•
e#ng (#m# K - meni"
•
e#ng o&#( #"#* '#%si#( s#"* sisi, #"#* &e#ng *m*m !i!#7*(*i &e#ng'#%si#(
•
Be%*(#ng #"#* (ebi7 !#%i &#(i !#(#m 2+ #m.
H. Di*%nosis An*#nesis& Bi#s#n@# !i!#'#"&#n %i)#@#" &e#ng !em#m '#!# #nggo"#
&e(*#%g# @#ng (#inn@# 8#@#7, ib*, #"#* s#*!#%# &#n!*ng:.
Pe#e(is**n Neu(olo%is &"i!#& !i!#'#"&#n &e(#in#n.
Pe#e(is**n L*$o(*o(iu# & 'eme%i&s##n %*"in "i!#& !i#n*%&#n, &e?*#(i
*n"*& mengev#(*#si s*mbe% ine&si #"#* men?#%i 'en@eb#b 8!#%#7 "e'i, e(e&"%o(i", !#n g*(#!#%#7:.
+
L*mb#( P*ngsi
?*%ig# meningi"is, *m*% &*%#ng !#%i 2 b*(#n !i7#%*s&#n
!#n *m*% !i #n"#%# 25 b*(#n !i#n*%&#n.
Pe#e(is**n R*'iolo%i & 5%#@ &e'#(#, $T s?#n &e'#(# #"#* MRI "i!#&
%*"in !#n 7#n@# !i&e%#&#n #"#s in!i&#si.
In!i&#si $T s?#n $T S?#n #"#* MRI 6 &e(#in#n ne*%o(ogi o&#( mene"#' 87emi'#%esis:
#"#*
&em*ng&in#n
#!#n@#
(esi
8mi&%ose#(i, s'#s"isi"#s: #"#* "e%!#'#" "#n!#
s"%*&"*%#(
!i o"#&.
'ening&#"#n "e&#n#n
in"%#&%#ni#( 8&es#!#%#n men*%*n, m*n"#7 be%*(#ng, UUB menono(, '#%esis N.4I, e!em# '#'i(:
•
Pe#e(is**n 7*i(*n se(e$(os+in*l :CSS; 6 "in!#&#n '*ngsi (*mb#( *n"*&
'eme%i&s##n $SS !i(#&*&#n *n"*& meneg#&&#n #"#* men@ing&i%&#n &em*ng&in#n meningi"is. P#!# b#@i &e?i(, &(inis meningi"is "i!#& e(#s, m#&# "in!#&#n '*ngsi(*mb#( !i&e%#&#n !eng#n &e"en"*#n seb#g#i be%i&*" 6
. B#@i 2 b*(#n 6 !i7#%*s&#n.
2. B#@i #n"#%# 2 b*(#n 6 !i#n*%&#n.
3. B#@i K b*(#n 6 "i!#& %*"in, &e?*#(i bi(# #!# "#n!#5"#n!# meningi"is.
•
Pe#e(is**n Ele(o Ense*lo%(*i :EEG; & "i!#& !i%e&omen!#si&#n,
&e?*#(i '#!# &e#ng !em#m @#ng "i!#& &7#s 8mis#(n@# &e#ng !em#m &om'(i&#"# '#!# #n#& *si# K / "#7*n #"#* &e#ng !em#m o&#(. I. Di*%nosis B*n'in% •
Meningi"is
-
•
Ense#(i"is
•
Abses o"#&
J. Pen**l*s*n**n Tin!#&#n #)#( @#ng mes"i !i(#&*&#n #!#(#7 menem'#"&#n #n#& '#!# 'osisi mi%ing !#n 7#ng#". Se"e(#7 #i% meng*#', !em#m #&#n "*%*n. Ti!#& 'e%(* mem#s*&&#n #'# '*n !i #n"#%# gigi. J#ng#n mem#s*&&#n sen!o& #"#* #%i &e !#(#m m*(*" #n#& *n"*& men?eg#7 (i!#7n@# "e%gigi".H#( ini "i!#& #!# g*n#n@#, *s"%* be%b#7#@# &#%en# gigi !#'#" '#"#7 #"#* #%i (*&#. Mi%ing&#n 'osisi #n#& se7ingg# i# "i!#& "e%se!#& #i% (i*%n@#. J#ng#n men?ob# men#7#n ge%#&#n #n#&.T*%*n&#n !em#m !eng#n memb*&# b#* !#n men@e&# #n#& !eng#n #i% se!i&i".
A!# 3 7#( @#ng 'e%(* !i&e%#&#n '#!# 'en#"#(#&s#n##n &e#ng !em#m @#i"*6
. Pengob#"#n #se #&*"
2. Men?#%i !#n mengob#"i 'en@eb#b
3. Pengob#"#n '%oi(#&sis "e%7#!#' be%*(#ngn@# &e#ng !em#m
Pengobatan Fase Akut
P#!# )#&"* &e#ng '#sien !imi%ing&#n *n"*& men?eg#7 #s'i%#si (*!#7 #" #* m*n"#7#n
!#n
!i*s#7#&#n
#(#n
n##s
7#%*s
beb#s
#g#%
o&sigenis#si
"e%#min.Pe%7#"i&#n &e#!##n vi"#( se'e%"i &es#!#%#n, "e&#n#n !#%#7, s*7*, 'e%n##s#n, !#n *ngsi #n"*ng. S*7* "*b*7 @#ng "inggi !i"*%*n&#n !eng#n &om'%es #i% 7#ng#" !#n 'embe%i#n #n"i'i%e"i&.
/
e#ng !em#m "e%#!i #&ib#" #!#n@# !em#m, m#&# "**#n *"#m# 'engob#"#n #!#(#7 men?eg#7 "e%#!in@# 'ening&#"#n !em#m o(e7 &#%en# i"* 'embe%i#n ob#" ob#"#n #n"i'i%e"i& s#ng#" !i 'e%(*&#n. b#"5ob#"#n @#ng !#'#" !ig*n#&#n seb#g#i #n"i'i%e"i& #!#(#7 '#%#se"#mo( 15-mg>&gbb>7#%i se"i#' +5/ #m #"#* ib*'%oen -51 mg>&gbb>7#%i se"i#' +5/ #m.
Di#Ce'#m #!#(#7 ob#" @#ng '#(ing ?e'#" meng7en"i&#n &e#ng. Ee& "e%#'e*"i& !i#Ce'#m s#ng#" ?e'#", @#i"* #n"#%# 31 !e"i& s#m'#i - meni" !#n ee& "o&si& @#ng se%i*s 7#m'i% "i!#& !i*m'#i #'# bi(# !ibe%i&#n se?#%# 'e%(#7#n !#n !osis "i!#& me(ebi7i -1 mg 'e%s*n"i&#n. Di#Ce'#m !#'#" !ibe%i&#n se?#%# in"%#ven# !#n in"%#%e?"#(. Dosis !i#Ce'#m in"%#ven# 1,351,- mg>&gBB>&#(i !eng#n &e?e'#"#n 52 mg>meni" !eng#n !osis m#&sim#( 21 mg. Bi(# &e#ng be%7en"i sebe(*m !i#Ce'#m 7#bis, 7en"i&#n 'en@*n"i&#n, "*ngg* seben"#% !#n bi(# "i!#& "imb*( &e#ng (#gi #%*m !i?#b*".
Pembe%i#n !i#Ce'#m se?#%# in"%#ven# '#!# #n#& @#ng &e#ng se%ing&#(i men@*(i"&#n, ?#%# 'embe%i#n @#ng m*!#7, se!e%7#n# !#n ee&"i me(#(*i %e&"*m "e(#7 !ib*&"i&#n &e#m'*7#nn@# 8n*!sen, 909 Ism#e( !&&., 9 #s'#%i !&&., 9:. Pembe%i#n !i(#&*&#n '#!# #n#&>b#@i !#(#m 'osisi mi% ing> men*ngging !#n !eng#n %e&"io( @#ng **ngn@# !io(esi v#se(in, !im#s*&&#ni#7 'i'# s#(*%#n &e(*#% %e&"io( &e %e&"*m se!#(#m 3 5 - ?m. em*!i#n %e&"io( !i'i#" 7ingg# &osong be"*( !#n se(#n*"n@# *n"*& bebe%#'# meni" (*b#ng !*b*% !i"*"*' !eng#n ?#%# me%#'#"&#n &e!*# m*s&*(*s g(*"e*s. Dosis !i#Ce'#m in"%#%e?"#( @g !#'#" !ig*n#&#n #!#(#7 - mg 8BB1 &g: #"#* 1 mg 8BBK1 &g:. Bi(# &e#ng "i!#& be%7en"i !#'#" !i*(#ng se(#ng - meni" &em*!i#n, bi(# "i!#& be%7en"i *g# be%i&#n eni"oin !eng#n !osis #)#( 1521 mg>&gBB se?#%# in"%#ven# 'e%(#7#n5(#7#n mg>&gBB>meni". Se"e(#7 'embe%i#n eni"oin, 7#%*s !i(#&*&#n 'embi(#s#n !eng#n N#$( isio(ogis &#%en# eni"oin be%si#" b#s# !#n men@eb#b&#n i%i"#si ven#.
Bi(# &e#ng be%7en"i !eng#n !i#Ce'#m, (#n*"&#n !eng#n 'embe%i#n enob#%bi"#( !osis %*m#"#n. Un"*& 2 7#%i 'e%"#m# !ibe%i&#n !osis 51 mg>&gBB>7#%i !ib#gi
0
!#(#m 2 !osis, *n"*& 7#%i57#%i be%i&*"n@# !eng#n !osis +5- mg>&gBB>7#%i !ib#gi 2 !osis. Se(#m# &e#!##n be(*m memb#i&, ob#" !ibe%i&#n se?#%# s*n"i&#n !#n se"e(#7 memb#i& 'e%o%#(. H#%*s !i'e%7#"i&#n b#7)# !osis "o"#( "i!#& bo(e7 me(ebi7i 211 mg>7#%i &#%en# ee& s#m'ingn@# #!#(#7 7i'o"ensi, 'en*%*n#n &es#!#%#n, !#n !e'%esi 'e%n##s#n.
Mencari dan Mengobati Penyebab
Peme%i&s##n &em*ng&in#n
?#i%#n
meningi"is,
se%eb%os'in#( "e%*"#m#
!i(#&*&#n
'#!#
'#sien
*n"*& &e#ng
men@ing&i%&#n !em#m
@#ng
'e%"#m#.#(#*'*n !emi&i#n &eb#n@#&#n !o&"e% me(#&*&#n '*ngsi (*mb#( 7#n@# '#!# &#s*s @#ng !i?*%ig#i seb#g#i meningi"is, mis#(n@# bi(# #!# ge#(# meningi"is #"#* bi(# &e#ng !em#m be%(#ngs*ng (#m#.
Pengobatan Profilaksis Terhadap Berulangnya Kejang Demam
Pengob#"#n ini !ib#gi #"#s 2 b#gi#n, @#i"*6
1. Profilaksis intermiten
Un"*& men?eg#7 "e%*(#ngn@# &e#ng &emb#(i !i&em*!i#n 7#%i, 'en!e%i"# @#ng men!e%i"# &e#ng !em#m se!e%7#n# !ibe%i&#n !i#Ce'#m se?#%# o%#( *n"*& '%oi(#&sis in"e%mi"en !eng#n !osis 1,351,- mg>&gBB>7#%i !ib#gi !#(#m 3 !osis s##" '#sien !em#m. Di#Ce'#m !#'#" *g# !ibe%i&#n se?#%# in"%#%e?"#( "i#' #m seb#n@#& - mg 8BB1 &g: !#n 1 mg 8BBK1&g: se"i#' '#sien men*n*&#n s*7* (ebi7 !#%i 3,-$.
P%oi(#&sis in"e%mi"en ini seb#i&n@# !ibe%i&#n s#m'#i &em*ng&in#n #n#& *n"*& men!e%i"# &e#ng !em#m se!#%7#n# s#ng#" &e?i(, @#i"* s#m'#i se&i"#% *m*% + "#7*n.
2. Profilaksis jangka panjang
P%oi(#&sis #ng&# '#n#ng be%g*n# *n"*& men#min "e%!#'#"n@# !osis "e%#'e*"i& @#ng s"#bi( !#n ?*&*' !i!#(#m !#%#7 'en!e%i"# *n"*& men?eg#7 "e%*(#ngn@# &e#ng !em#m be%#" @#ng !#'#" men@eb#b&#n &e%*s#&#n o"#& "e"#'i "i!#& !#'#" men?eg#7 "e%#!in@# e'i(e'si !i&em*!i#n 7#%i.P%oi(#&sis "e%*s5mene%*s se"i#' 7#%i !eng#n enob#%bi"#( 35- mg> &gBB>7#%i !ib#gi !#(#m 2 !osis.b#" (#in @#ng !#'#" !ig*n#&#n #!#(#7 #s#m v#('%o#" !eng#n !osis -5 +1 mg>&gBB>7#%i. An"i&onv*(s#n '%oi(#&sis "e%*s mene%*s !ibe%i&#n se(#m# 52 "#7*n se"e(#7 &e#ng "e%#&7i% !#n !i7en"i&#n be%"#7#' se(#m# 52 b*(#n.
Pengob#"#n #ng&# '#n#ng 7#n@# !ibe%i&#n i&# &e#ng !em#m men*n*&&#n ?i%i seb#g#i be%i&*" 8s#(#7 s#"*: 6
•
e#ng (#m# K - meni"
•
e(#in#n
ne*%o(ogis
7emi'#%esis,
'#%esis
@#ng
n@#"#
sebe(*m>ses*!#7
To!!,
se%eb%#(
'#(s@,
%e"#%!#si
7i!%ose#(*s.
•
&e#ng
e#ng o&#(.
Pengob#"#n #ng&# '#n#ng !i'e%"imb#ng&#n i&# 6
•
e#ng be%*(#ng 2&#(i #"#* (ebi7 !#(#m 2+ #m.
•
e#ng !em#m "e%#!i '#!# b#@i &*%#ng !#%i 2 b*(#n
•
e#ng !em#m K + &#(i 'e% "#7*n.
men"#(,
9
Al%o(i#e Pen*n%*n*n Ke1*n% Au '*n S*us on
21
. P(o%nosis Deng#n 'en#ngg*(#ng#n @#ng "e'#" !#n ?e'#", '%ognosis &e#ng !em#m b#i& !#n "i!#& 'e%(* men@eb#b&#n &em#"i#n.D#%i 'ene(i"i#n @#ng #!#, %e&*ensi "e%*(#ngn@# &e#ng be%&is#% #n"#%# 2- 5 -1, @#ng *m*mn@# "e%#!i '#!# / b*(#n 'e%"#m#.
2
e#ng !em#m #&#n be%*(#ng &emb#(i '#!# seb#gi#n &#s*s. F#&"o% %esi&o be%*(#ngn@# &e#ng !em#m #!#(#7 6
5
Ri)#@#" &e#ng !em#m !#(#m &e(*#%g#
5
Usi# &*%#ng !#%i 2 b*(#n
5
Tem'e%#"*% @#ng %en!#7 s##" &e#ng
5
$e'#"n@# &e#ng se"e(#7 !em#m.
Ji&# se(*%*7 #&"o% !i #"#s #!#, &em*ng&in#n be%*(#ngn@# &e#ng !em#m #!#(#7 1, se!#ng&#n bi(# "i!#& #!# #&"o% "e%eb*" &em*ng&in#n be%*(#ngn@# &e#ng !em#m 7#n@# 15-. em*ng&in#n be%*(#ngn@# &e#ng !em#m bes#% '#!# "#7*n 'e%"#m#.
F#&"o% %esi&o "e%#!in@# e'i(e'si 6
5
e(#in#n ne*%o(ogis #"#* 'e%&emb#ng#n @#ng e(#s sebe(*m &e#ng !em#m 'e%"#m#.
5
e#ng !em#m &om'(e&s.
5
Ri)#@#" e'i(e'si '#!# o%#ng "*# #"#* s#*!#%# &#n!*ng.
M#sing5m#sing #&"o% %isi&o mening&#"&#n &em*ng&in#n &e#!i#n e'i(e'si +5/, &ombin#si !#%i #&"o% %esi&o "e%seb*" mening&#"&#n &em*ng&in#n e'i(e'si men#!i 15+9. em*ng&in#n men#!i e'i(e'si "i!#& !#'#" !i?eg#7 !eng#n 'embe%i#n ob#" %*m#" '#!# &e#ng !em#m.
22
BAB III KESIMPULAN P#!# &#s*s !i #"#s, '#sien (#&i5(#&i be%*si# 3 b*(#n !i!i#gnosis !eng#n &e#ng !em#m &om'(e&s e" ?#*s# s*s' b#?"e%i#( ine?"ion. e#ng !em#m me%*'#&#n s*#"* b#ng&i"#n &e#ng @#ng "e%#!i &#%en# &en#i&#n s*7* "*b*7 8s*7* %e?"#( !i#"#s 3 $: @#ng !iseb#b&#n o(e7 s*#"* '%oses e&s"%#&%#ni*m. A!# 2 ben"*& &e#ng !em#m (menurut Livingstone:, @#i"*6 8: e#ng !em#m se!e%7#n# 8Sim'(e Feb%i(e SeiC*%e:, !eng#n ?i%i5?i%i ge#(# &(inis seb#g#i be%i&*" e#ng be%(#ngs*ng sing&#", - meni", &e#ng *m*m "oni& !#n #"#* &(oni&, *m*mn@# be%7en"i sen!i%i, "#n'# ge%#&#n o&#( #"#* be%*(#ng !#(#m 2+ #m. 82: e#ng !em#m &om'(i&#"# 8$om'(e< Feb%i(e SeiC*%e:, !eng#n ?i%%i5?i%i ge#(# &(inis seb#g#i be%i&*" 6 e#ng (#m# K - meni", &e#ng o&#( #"#* '#%si#( s#"* sisi, #"#*
23
&e#ng *m*m !i!#7*(*i &e#ng '#%si#(, be%*(#ng #"#* (ebi7 !#%i &#(i !#(#m 2+ #m. P#!# '#sien ini, !#%i #n#mnesis !i!#'#"&#n &e(*7#n &e#ng @#ng !i#)#(i o(e7 !em#m. P#!# &e#!##n !em#m, &en#i&#n $ #&#n meng#&ib#"&#n &en#i&#n me"#bo(isme b#s#( 15- !#n &eb*"*7#n o&sigen #&#n mening&#" s#m'#i 21. J#!i '#!# &en#i&#n s*7* "*b*7 "e%"en"* !#'#" "e%#!i 'e%*b#7#n &eseimb#ng#n !#%i memb%#n se( ne*%on, !#n !#(#m )#&"* @#ng sing&#" !#'#" "e%#!i !i*si ion &#(i*m (is"%i&.Le'#s m*#"#n (is"%i& ini !emi&i#n bes#%n@# se7ingg# !#'#" me(*#s &e se(*%*7 se( m#*'*n &e memb%#n "e"#ngg#n@# !eng#n b#n"*#n b#7#n @#ng !iseb*" ne*%o"%#nsmi""e% !#n "e%#!i(#7 &e#ng. Ti#' #n#& mem'*n@#i #mb#ng &e#ng @#ng be%be!# !#n "e%g#n"*ng !#%i "inggi %en!#7n@# #mb#ng &e#ng seo%#ng #n#& men!e%i"# &e#ng '#!# &en#i&#n s*7* "*b*7 "e%"en"*. P#!# #n#& !eng#n #mb#ng &e#ng @#ng %en!#7, &e#ng s*!#7 !#'#" "e%#!i '#!# s*7* 3$, se!#ng&#n '#!# #n#& !eng#n #mb#ng &e#ng @#ng "inggi, &e#ng b#%* !#'#" "e%#!i '#!# s*7* +1$ #"#* (ebi7. Se(#in i"* '#sien "e%seb*" s*!#7 'e%n#7 meng#(#mi &e#ng se#& *si# b*(#n. P#!# &e#ng @#ng be%(#ngs*ng (#m# bi#s#n@# !ise%"#i "e%#!in@# #'ne#, mening&#"n@# &eb*"*7#n o&sigen !#n ene%gi *n"*& &on"%#&si o"o" s&e(e" se!#ng&#n o"o" 'e%n##s#n "i!#& eisien se7ingg# "i!#& sem'#" be%n##s @#ng #&7i%n@#
"e%#!i
7i'o&semi#,
7i'e%&#'ne#,
7i'og(i&emi#,
(#&"#"
#si!osis
!iseb#b&#n me"#bo(isme #n#e%ob, 7i'o"ensi #%"en#( !ise%"#i !en@*" #n"*ng@#ng "i!#& "e%#"*% !#n s*7* "*b*7 @#ng sem#&in mening&#" o(e7 &#%en# mening&#"n@# #&"ivi"#s o"o" !#n se(#n*"n@# men@eb#b&#n me"#bo(isme o"o" mening&#". F#&"o% "e%'en"ing #!#(#7 g#ngg*#n 'e%e!#%#n !#%#7 meng#&ib#"&#n 7i'o&si# se7ingg# meninggi&#n 'e%me#bi(i"#s &#'i(e% !#n "imb*( oe!em o"#& @#ng meng#&ib#"&#n &e%*s#&#n se( ne*%on. D#%i &en@#"##n ini !#'#" !isim'*(&#n b#7)# be%*(#ngn@# &e#ng !em#m (ebi7 se%ing "e%#!i '#!# #mb#ng &e#ng @#ng %en!#7 se7ingg# !i !#(#m 'en#ngg*(#ng#nn@# 'e%(* !i'e%7#"i&#n '#!# "ing&#" s*7* be%#'# 'en!e%i"# men#!i &e#ng.
2+
P#!# '#sien ini *g# "e%!#'#" 7emi'7#%#se !e<"%#, Bi#s#n@# "e%#!i '#!# 'en!e%i"# @#ng meng#(#mi &e#ng (#m# 8be%(#ngs*ng (ebi7 !#%i se"eng#7 #m: b#i& &e#ng @#ng be%si#" *m*m m#*'*n &e#ng o&#(. e#ng o&#( @#ng "e%#!i ses*#i !eng#n &e(*m'*7#nn@#. M*(#5m*(# &e(*m'*7#n be%si#" (#?i!, ses*!#7 2 mingg* "imb*( &e#!##n s'#s"isi"#s. Di'e%&i%#&#n = 1,2 DS meng#(#mi 7emi'#%ese ses*!#7 &e#ng (#m#. Fo"o 5%#@ &e'#(# !#n 'en?i"%##n se'e%"i ?om'*"e! "omog%#'7@ s?#n 8$T5s?#n: #"#* m#gne"i? %eson#n?e im#ging 8MRI: #%#ng se&#(i !i&e%#&#n, "i!#& %*"in !#n 7#n@# #"#s in!i&#si se'e%"i6
. e(#in#n ne*%o(ogi& o&#( @#ng mene"#' 87emi'#%e5sis:
2.P#%esis ne%v*s 4I
3.P#'i(e!em# J#!i $T s?#n @#ng !ibe%i&#n '#!# '#sien ini *g# s*!#7 "e'#" )#(#*'*n #%#ng !i(#&*&#n #&#n "e"#'i '#sien ini "e%!#'#" #!#n@# 7emi'#%esis !e<"%# !i(#&*&#n $T s?#n
*n"*& menen"*&#n &e(#in#n s"%*&"*%#( be%*'# &om'(e&s "*ngg#( #"#*
m*("i'e( A!# 3 7#( @#ng 'e%(* !i&e%#&#n '#!# 'en#"#(#&s#n##n &e#ng !em#m @#i"*6 8: Pengob#"#n #se #&*" . 82: Men?#%i !#n mengob#"i 'en@eb#b 83: Pengob#"#n '%oi(#&sis "e%7#!#' be%*(#ngn@# &e#ng !em#m.
P#!# '#sien ini
s*!#7 memi(i&i in!i&#si *n"*& !ibe%i&#n "#"#(#&s#n# &e#ng !em#m #ng&# '#n#ng, !eng#n !ibe%i&#n #s#m v#('%o#" s#m'#i "#7*n 'e%io!e beb#s &e#ng. P#sien ini *g# men!#'#" "e%#'i Am'i?i((in !eneng#n !osis In"%#&%#ni#(, &#%en# '#!# '#sien ini "e%!#'#" &e?*%ig##n !ei?i" ne*%o(ogis !eng#n #!#n@# 7ei'7#s#%e !e&s"%# !#n %) &e#ng '#!# *m*% #n#& b*(#n se7#%*sn@# s*!#7 !i(#&*&#n L*mb#( P*ngsi *n"*& men@ing&i%&#n #!#n@# ine&si #"#* &e(#in#n in"%#?%#ni#(.
2-
2/
BAB IDA,TAR PUSTAKA
. Ame%i?#n A?#!em@ o Pe!i#"%i?s. P%#?"i?e P#%#me"e% 6 Long5"e%m T%e#"men" o T7e $7i(! )i"7 Feb%i(e SeiC*%es. Pe!i#"%i?s 999 13 310 1.
2. P*s'onego%o. D. H#%!iono !&&. onsens*s Pen#"#(#&s#n##n e#ng Dem#m. I&#"#n Do&"e% An#& In!onesi#. J#&#%"#, 211/.
3. R*!o('7 AM. Febrile Seizures. Rudoplh Pediatris. E!isi &e521. A''(e"on !#n L#nge, 2112.
+. D*e% P, B#*m#nn RJ. A S@no'sis o "7e Ame%i?#n A?#!em@ o Pe!i#"%i?sP%#?"i?eP#%#me"e% on T7e Ev#(*#"ion #n! T%e#"men" o $7i(!%en )i"7 Feb%i(eSeiC*%es. Pe!i#"%i?s in Revie), vo(. 21, No. , 9996 2- 0.
-. Febrile Seizures Fat Sheets! "ational #nstitutes of "eurolog$ and Stroke Di*n!*7
'#!#
"#ngg#(
21
?"obe%
2119.
Di!#'#"&#n
!#%i6
))).nin!s.ni7.gov>!iso%!e%s>eb%i(eseiC*%es>!e"#i(eb%i(eseiC*%es.7"m
/. 7""'6>>))).(i''oins*%#n?e.?om>&e#ng5!em#m> !i #&ses 1 #'%i( 21+
