Kejang Berulang dan Status Epileptikus pada Ensefalitis sebagai Faktor Risiko Epilepsi Pascaensefalitis
Sari
Latar belakang. Epilepsi pascaensefalitis merupakan salah satu komplikasi ensefalitis yang sering terjadi serta memerlukan tata laksana jangka panjang dan menurunkan kualitas hidup pasien. Kejang berulang dan status epileptikus pada ensefalitis dicurigai dapat meningkatkan risiko terjadi epilepsi pascaensefalitis.
Tujuan. Mengetahui apakah risiko epilepsi pascaensefalitis lebih tinggi pada pasien yang mengalami kejang berulang dan status epileptikus pada ensefalitis.
Metode. Penelitian kasus kontrol pada pasien pascaensefalitis usia 6 bulan-18 tahun dilakukan di bangsal anak RSUP Dr. Sardjito, Yogyakarta. Kelompok kasus terdiri dari 26 pasien dengan diagnosis epilepsi pascaensefalitis, 27 pasien pascaensefalitis dengan gejala sisa selain epilepsi atau tanpa gejala sisa sebagai kelompok kontrol. Data klinis subyek selama episode ensefalitis akut didapatkan dari rekam medis pasien saat dirawat. Kekuatan hubungan antara variabel independen dengan variabel dependen diketahui berdasarkan analisis bivariat dan analisis multivariat.
Hasil. Kejang berulang ensefalitis akut meningkatkan risiko terjadinya epilepsi pascaensefalitis (OR 3,6;95 % CI 1,0-12,7; p<0,05). Status epileptikus ensefalitis secara klinis meningkatkan risiko terjadinya epilepsi pascaensefalitis, tetapi secara statistik tidak bermakna (OR 2,4;95 % CI 0,7-8,2; p>0,05).
Kesimpulan. Kejang berulang ensefalitis meningkatkan risiko terjadinya epilepsi pascaensefalitis. Status epileptikus pada ensefalitis secara klinis meningkatkan risiko terjadinya epilepsi pascaensefalitis, tetapi secara statistik tidak bermakna.
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Lin JJ, Lin KL, Wang HS, Hsia SH and Awau CT. Analiysis of status epilepticus related presumed encephalitis in children. Eur J Paediatr Neurol 2008;12:32-7.
Annegers JF, Hauser WA, Beghi E, Nicosi A, Kurland LT. The risk of unprovoked seizures after encephalitis and meningitis. Neurol 1992;42:1513-8.
Lee WT, Yu TW, Chang WC, Shau WY. Risk factors for postencephalitic epilepsy in children: a hospital based study in Taiwan. Eur J Paediatr Neurol 2007;11:302-9.
Chen YJ, Fang PC and Chow JC. Clinical characteristics and prognostic factors of postencephalitic epilepsy in children. J Child Neurol 2006; 21:1047-51.
Ooi MH, Lewthwaite P, Lai BF. Epidemiology, clinical features and long term prognosis of Japanese encephalitis in Central Sarawak. Malasyia, 1997-2005. Clin Infect Dis 2008;47:458-68.
Sastroasmoro S, Ismael S. Dasar-dasar metodologi penelitian Klinis. Edisi 2. Jakarta: CV. Sagung Seto; 2002.
Fowler A, Stodberg T, Eriksson M and Wickstrom R. Long-term outcomes of acute encephalitis in childhood. Pediatric 2010;126:e828-34.
Trinka E, Dubeau F, Andeman F. Clinical finding, imaging characteristic and outcome in catastrophic postencephalitic epilepsy. Epileptic Dis 2000; 2;3:153-62.
Friedman MJ, Sharieff GQ. Seizures in children. Pediatr Clin N Am 2006;53:257-77.
Pohlmann EB, Gass A and Peters CN Evolution of MRI changes and development of bilateral hippocampal sclerosis during long lasting generalized status epilepticus. J Neurol Neurosurg Psychiatry 2004;75:898-900.
Chin RF, Neville BG, Peckham C. Incidence, cause, and short-term outcome of convulsive status epilepticus in childhood: prospective population-based study. Lancet 2006;368:222-9.
Sahin M, Menache CC, Holmes GL, Riviello Jr. Prolonged treatment for acute symptomatic refractory status epilepticus: outcome in children. Neurology 2003;61:398-401.
Fujikawa DG. Prolonged seizures and cellular injury: understanding the connection. Epilepsy Behav 2005;7: S3-S11.
Holtkamp M, Othman J, Buchheim K and Meierkord H. Predictors and prognosis of refractory status epilepticus treated in a neurological intensive care unit. J Neurol Neurosurg Psychiatry 2005;76:534-9.
Maegaki Y, Kutozawa Y and Hanaki KOK. Risk factors for fatality and neurological sequel after status epilepticus in children. Neuropediatrics 2005;36:186-92.
Borges K, Gearing M and McDermott DL. Neuronal and glial pathological changes during epileptogenesis in the mouse pilocarpine model. Exp Neurol 2003;182:21-34.
Wasterlain CG, Denson GF and Penix IR Pathophysiological mechanisms of brain damage from status epilepticus. Epilepsia 1993;34(suppl I):S37-53.
DeGiorgo CM, Tomiyasu U and Gott PS Hippocampal pyramidal cell loss in human status epilepticus. Epilepsia 1992;33:23-7.
Hong KS, Cho YJ and Lee SK Diffusion changes suggesting predominant vasogenic oedema during partial status epilepticus. Seizure 2004;13:317-21.
Nixon J, Bateman D and Moss T. An MRI and neuropathological study of case of fatal status epilepticus. Seizure. 2001;10:588-91.
Treiman DM. Will brain damage after status epilepticus be history in 2010?. Prog Brain Res 2002;135:471-8.
Liu RS, Lemieux I and Bell GS. Progressive neocortical damage in epilepsy. Ann Neurol 2003;53:312-24.
Herrmann EK, Hahn K, Kratzer C, Seggern I, Zimmer C, Schielke, E. Status epilepticus as a risk factor for postencephalitic parenchyma loss evaluated by ventricle brain ratio measurement on MR Imaging. AJNR Am J Neuroradiol 2006;27:1245-51.
Ohtsuka Y, Yoshinaga H and Kobayashi K. Predictors and underlying causes of medically intractable localization-related epilepsy in childhood. Pediatr Neurol 2001;24:209-13.
Marks DA, Kim J, Spencer DD, Spencer SS. Characteristics of intractable seizures following meningitis and encephalitis. Neurology 1992;42:1513-8.
Barrera NM. Clinical, neuro-radiological and prognostik aspect of post-encephalitic catasthrophic epilepsies. Rev Neurol 2002;35(Suppl 1):30-8.
DOI: http://dx.doi.org/10.14238/sp15.3.2013.150-5
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