porto folio 1

7/25/2019 Porto Folio 1

1/24

CASE REPORT SESSION

KEJANG DEMAM

OLEH:Dr. YOLA NEWARY

PRESEPTOR:Dr. Rusdi, Sp. A(K)

BAGIAN ILMU KESEHATAN ANAK RSUP DR. M. DAMIL!AKULTAS KEDOKTERAN UNI"ERSITAS ANDALAS

PADANG

#$%#

BAB I

TINJAUAN PUSTAKA

1.1 DEFINISI

1


2/24

K&'* d&++ d- */i0 /&'* 1* 0&r'di pd /&i/ su-u 0uu- (su-u

r&20 di0s 34 5) 1* dis&/ 6&- su0u pr6s&s &/s0r/riu+. %K&'* d&++

+&rup/ /&i &ur66*is 1* pi* s&ri* di'u+pi pd /7/, 0&ru0+ pd

*66* u+ur 3 u s+pi 8 0-u. M&uru0 Consensus statement on febrile seizures (1980),

/&'* d&++ d- /&'di pd 1i 0u / 1* &r-uu* d&* d&++ 0&0pi

0id/ p&r- 0&ru/0i d1 i9&/si i0r/ri 0u p&1& 0&r0&0u. A/ 1* p&r-

/&'* 0p d&++ d 1i &ru+ur /ur* dri +i**u 0id/ 0&r+su/ d+ /&'*

d&++. K&'* d&++ -rus di&d/ d&* &pi&psi,1i0u 1* di0di d&* /&'*

&ru* 0p d&++.%,#,3

D&9iisi ii +&1i*/ir/ /&'* 1* dis&/ p&1/i0 sr9 s&p&r0i +&i*i0is,

&s&90i0is 0u &s&96p0i. K&'* pd /&d ii +&+pu1i pr6*6sis &r&d d&*

/&'* d&++ /r& /&d 1* +&dsri1 +&*&i sis0&+ susu sr9 pus0. D-uu

Li;i*s06 +&+*i /&'* d&++ +&'di # *66*, 1i0u /&'* d&++ s&d&r- (simle

febrile !on"ulsion) d &pi&psi 1* dipr6;6/si 6&- d&++ (eilesi tri##ere$ of b% fe"er)

H+pir 3< dripd / 1* &ru+ur di =- 8 0-u p&r- +&d&ri01

(Mii2-p, %>?4). W&*+ (%>3>) d Mii2-p (%>8>) dri p&r26 i0* &r/&si+pu

-= su-u 1* 0i**i dp0 +&1&/ 0&r'di1 */i0 /&'*. %

T&r'di1 */i0 /&'* d&++ &r*0u* /&pd u+ur, 0i**i s&r0 2&p01 su-u

+&i*/0 (W&*+, %>3>@ Pri2-rd d M2Gr&, %>84). !/06r -&r&di0s 'u* +&+pu1i

p&r. L&67Bu2-0- (%>%) &rp&dp0 - = /&p&/ 0&r-dp */i0 /&'*

d&++ di0uru/ 6&- s&u- *& d6+i d&* p&&0rsi 1* 0id/ s&+pur. L&6

(%>>) &rp&dp0 - = %,#< **60 /&ur* p&d&ri0 +&+pu1i ri=10 /&'*

s&d*/ pd / 6r+ -1 3


3/24

0&rdp0 &&rp p&r&d /&2i d+ p&**66* 0&rs&u0, +&1*/u0 '&is /&'*,

0i**i1 d&++, usi p&d&ri0, +1 /&'* &r*su*, *+r r&/+ 60/ d

i1%,#

I. Ksi9i/si /&'* d&++ +&uru0 Pri2-rd d M2 Gr

Pri2-rd d M2 Gr& +&+*i /&'* d&++ 0s # *66*, 1i0u:

%. K&'* d&++ s&d&r-

#. K&'* d&++ 0id/ /-s

5iriC2iri /&'* d&++ s&d&r- i-:#

%. K&'*1 &rsi90 si+&0ris, r0i1 / 0&ri-0 &* d 0u*/i /iri 1*

/&'* s+ s&p&r0i 1* /

#. Usi p&d&ri0 0r ? u 7 0-u

3. Su-u %$$ ! (3,4 5) 0u &i-

. L+1 /&'* &r*su* /ur* dri 3$ +&i0

8. K&d &ur66*1 6r+ d s&0&- /&'* 'u* 0&0p 6r+

?. EEG 1* diu0 s&0&- 0id/ d&++ d- 6r+

K&'* d&++ 1* 0id/ +&+&u-i u0ir 0&rs&u0 di0s di*66*/ s&*i /&'* d&++

0id/ /-s

II. Ksi9i/si /&'* d&++ +&uru0 Li;i*s06#

Li;i*s06 +&+*i d+:

%. /&'* d&++ s&d&r-

#. Epi&ps1 1* di2&0us/ 6&- d&++

5iri72iri /&'* d&++ s&d&r-:#

%. K&'* &rsi90 u+u+

#. L+1 /&'* &r*su* si*/0 (/ur* dri %8 +&i0)

3. Usi =/0u /&'* d&++ p&r0+ +u2u /ur* dri ? 0-u

. !r&/u&si s&r* %7 /i d+ s0u 0-u

8. EEG 6r+

/&'* d&++ 1* 0id/ s&sui d&* 2iri 0&rs&u0 di0s di*66*/ s&*i &pi&ps1 1*

di2&0us/ 6&- d&++

III. Ksi9i/si /&'* d&++ +&uru0 !u/u1+#

!u/u1+ 'u* +&+*i /&'* d&++ +&'di # *66*, 1i0u:

3


4/24

%. /&'* d&++ s&d&r-

#. /&'* d&++ /6+p&/s

5iri72iri /&'* d&++ s&d&r- +&uru0 !u/u1+:#

%. Pd /&ur* p&d&ri0 0id/ d ri=10 &pi&ps1

#. S&&u+1 0id/ d ri=10 2&d&r 60/ 6&- p&1& ppu

3. S&r* /&'* d&++ 1* p&r0+ 0&r'di 0r usi ? u 7 ? 0-u

. L+1 /&'* &r*su* 0id/ &i- dri #$+&i0

8. K&'* 0id/ &rsi90 96/

?. Tid/ didp0/ ***u 0u 6r+i0s ps2 /&'*

. S&&u+1 'u* 0id/ didp0/ 6r+i0s &ur66*is0 0u 6r+i0s

p&r/&+*

4. K&'* 0id/ &ru* d+ =/0u si*/0

/&'* d&++ 1* 0id/ s&sui d&* 2ri0&ri 0&rs&u0 di0s di*66*/ s&*i KD '&is

/6+p&/s

*i I+u K&s&-0 A/ su *i Sr9 A/ RS5M /r0, +&**u/

/ri0&ri Li;i*s06 1* 0&- di+6di9i/si s&*i p&d6+ u0u/ +&+u0 di*6sis /&'*

d&++, 1i0u:

%. U+ur / /&0i/ /&'* 0r ? u C ? 0-u

#. K&'* &r*su* -1 s&&0r s', 0id/ &i- dri %8 +&i0

3. K&'* &rsi90 u+u+

. K&'* 0i+u %? '+ p&r0+ s&0&- 0i+u1 d&++

8. 0id/ d d&9isi0 &ur66*is s&&u+ d s&sud- /&'*

?. P&+&ri/s EEG 1* diu0 s&0id/1 % +i**u s&sud- su-u 6r+ 0id/

+&u'u// /&i

. !r&/u&si */i0 /&'* d+ s0u 0-u 0id/ +&&i-i /i

/&'* d&++ di*i +&'di 3 /&6+p6/:

%. K&'* d&++ /6+p&/s

7 L+ %8 +&i0

7 !6/prsi 0u 96/ 1* +&'di u+u+

7 K&'* &ru* d+ # '+

#. K&'* d&++ s&d&r-

4


5/24

7 L+ F %8 +&i0

7 u+u+

7 K&'* 0id/ &ru* d+ # '+

3. K&'* d&++ pus (!&ri& S&iur& Pus)

7 K&'* d&++ 1* d u+ur ? 0-u

7 K&'* d&++ &rs+ d&* Epi&psi

7 S&r* /&'* 1* s&ri* %30-

7 P-&601p& K&'* D&++

7 Mu0si pd 2-& s6diu+ d GABA

FAKTOR RISIKO

!/06r risi/6 /&'* d&++ 1i0u d1 d&++, 9/06r ri=10 /&'* d&++ pd

6r* 0u 0u sudr /du*, p&r/&+* 0&r+0, ***u pd +s &60us, d

/dr 0riu+ r&d-. S&0&- /&'* d&++ p&r0+, s&/i0r 33 / / +&*+i

&ru*1 /&'* d&++ % /i 0u &i-, d s&/i0r > / +&*+i &ru*1 /&'*

d&++ 3 /i 0u &i-. R&si/6 &ru*1 /&'* d&++ +&i*/0 pd usi dii, 2&p01

/ +&dp0 /&'* s&0&- d&++ 0i+u, su-u 1* s*0 r&d- s0 /&'*, ri=10

/&ur* /&'* d&++, d ri=10 /&ur* &pi&psi.%

Du puu- s+pi #8< p&d&ri0 /&'* d&++ +&+pu1i /&ur* d&/0 (6r*7

0u d sudr /du*) 1* 'u* p&r- +&d&ri0 /&'* d&++.Tsu6i +&dp0/

-=isid& /&'* d&++ pd 6r* 0u p&d&ri0 /&'* d&++ i- %< d pd

sudr /du*1 ##


6/24

. P&ru- /&s&i+* 2ir 0u &&/0r6i0

8. Es&9i0is ;ir 1* ri* 0u 1* 0id/ di/&0-ui

?. Gu* s&+u 9/06r di0s

D&++ 1* 0&r'di s&0&- / dii+uissi 'u* dp0 +&+pr6;6/si /&'*

d&++. I+uissi 1* s&ri* +&1&/ d&++ d- DPT d 2+p/.%

P&&i0i.Lu+06i* pd #> p&d&ri0 /&'* d&++, didp0/ &&rp

p&1/i0 p&1& d&++.

T& %. P&1& d&++

P&1& d&++ 'u+- p&d&ri0

T6sii0is d0u 9ri*i0is %$$

O0i0is +&di /u0 >%

E0&ri0is*s0r6&0&ri0is ##

E0&ri0is*s0r6&0&ri0is dis&r0i d&-idrsi

Br6/6p&u+6i 34

Br6/i0is %

5+p/ %#

"ris& %

D&*u& %

Tid/ di/&0-ui ??

PATOFISIOLOGI1,5

M&s/ipu +&/is+& ps0i 0&r'di1 /&'* 0id/ di/&0-ui, &&rp 9/06r 9isi66*is

di**p &r0**u* '= 0s &r/&+*1 su0u /&'* %.

U0u/ +&+p&r0-/ -idup s& 0u 6r* 60/, dip&ru/ su0u &&r*i 1* didp0 dri

+&06is+&. B- /u u0u/ +&06is+& 60/ 1* 0&rp&0i* d- *u/6s. Si90 pr6s&s

i0u d- 6/sidsi di+ 6/si*& dis&di/ d&* p&r0r 9u*si pru7pru d

di0&rus/ /& 60/ +&ui sis0&+ /rdi6;s/u&r. di su+&r &&r*i 60/ d- *u/6s 1*

+&ui pr6s&s 6/sidsi dip&2- +&'di 5O#d ir.

S& di/&ii*i 6&- su0u +&+r 1* 0&rdiri dri p&r+u/ d+ &rup ipid d

p&r+u/ ur d- i6i/. D+ /&d 6r+ +&+r s& &ur6 dp0 diui d&*

+ud- 6&- i6 /iu+ (K) d s*0 sui0 diui 6&- i6 0riu+ (N) d &&/0r6i0 i1,

6


7/24

/&2ui i6 /6rid (57). A/i01 /6s&0rsi K d+ s& &ur6 0i**i d /6s&0rsi

N+&'di r&d- s&d*/ di ur s& &ur6 0&r'di /&d s&i/1. Kr& p&r&d

'&is d /6s&0rsi i6 di d+ d di ur s&, +/ 0&rdp0 p&r&d p60&si 1*

dis&u0 p60&si +&+r dri s& &ur6. U0u/ +&'* /&s&i+* p&0&si +&+r ii

dip&ru/ &&r*i d 0u &i+ N7K7ATPs& 1* 0&rdp0 pd p&r+u/ s&.

K&s&i+* p&0&si +&+r ii dp0 diu- 6&- d1 p&ru- /6s&0rsi

i6 diru* &/s0rs&u&r, r*s* 1* d0*1 +&dd/, +is1 +&/is, /i+i=i

0u ir is0ri/ dri s&/i0r1, d p&ru- dri p069isi66*i dri +&+r s&diri /r&

p&1/i0 0u /&0uru.

Pd /&d d&++, /&i/ %65 / +&*/i0/ /&i/ +&06is+& s

%$7%8< d /&u0u- 6/si*& / +&i*/0 s+pi #$


8/24

&r*su* si*/0, &rup s&r* 06i/ /6i/. B&0u/ /&'* 1* i dp0 'u* 0&r'di

s&p&r0i +0 0&ri/ /&0s d&* dis&r0i /&//u 0u /&&+-,*&r/ s&0/ &ru*

0p did-uui /&//u, 0u -1 s&0/ 0u /&//u 96/.#,3,,8

S&*i &sr /&'* &r*su* /ur* dri ? +&i0 d /ur* dri 4< 1*

&r*su* &i- dri %8 +&i0. S&ri* /i /&'* &r-&0i s&diri s&0&- +&dp0

p&r066* p&r0+. S&0&- /&'* &r-&0i / 0+p/ &-, +&*0u/, 0&r0idur pus, d

0id/ +&+&ri/ r&/si ppu u0u/ s&'&/ 0u dis&u0 p&ri6d& +&*0u/ si*/0 ps2

/&'*, 0&0pi s&0&- &&rp d&0i/ 0u +&i0, / 0&r*u d sdr /&+i 0p d&9isi0

&ur66*is. #

K&'* d&++ 1* &r*su* &i- + dri %8 +&i0 s&ri* &rsi90 96/ 0u

ui0&r d /d*7/d* dii/u0i 6&- pr&s& T66d (u+pu- s&+&0r ps2 s&r*

/&'*) 1* &r*su* &&rp '+ s+pi &&rp -ri. K&'* ui0&r 1* + dp0

dii/u0i 6&- -&+ipr&sis 1* +&&0p. B*/i0 /&'* 1* &r*su* + is1 &i-

s&ri* 0&r'di pd /&'* d&++ 1* p&r0+.#

DIAGNOSIS

Di*6sis /&'* d&++ di0&*// &rdsr/ /ri0&ri Li;i*s06 1* 0&-

di+6di9i/si, 1i0u:

%. U+ur / /&0i/ /&'* 0r ? u C ? 0-u

#. K&'* &r*su* -1 s&&0r s', 0id/ &i- dri %8+&i0

3. K&'* &rsi90 u+u+

. K&'* 0i+u %? '+ p&r0+ s&0&- 0i+u1 d&++

8. 0id/ d d&9isi0 &ur66*is s&&u+ d s&sud- /&'*

?. P&+&ri/s EEG 1* diu0 s&0id/1 % +i**u s&sud- su-u 6r+ 0id/

+&u'u// /&i

. !r&/u&si */i0 /&'* d+ s0u 0-u 0id/ +&&i-i /i

S&2r /iis u+u+1 0id/ sui0 u0u/ +&&*// di*6sis /&'* d&++,

d&* d1 *&' /&'* pd su-u d 1* 0i**i s&r0 0id/ didp0/ *&'

&ur66*is i d / s&*&r sdr s&0&- /&'* &ru. T&0pi p&ru dii*0 -= /&'*

8


9/24

d&* su-u d 1* 0i**i dp0 pu 0&'di pd /&i i, +is1 +&i*i0is 0u

&s&9i0is

P&+&ri/s 2ir s&r&r6spi dp0 di/u/ u0u/ +&1i*/ir/

/&+u*/i +&i*i0is, 0&ru0+ pd psi& /&'* d&++ 1* p&r0+ d d&* usi

/ur* dri % 0-u. S0 ii p&+&ri/s EEG 0id/ di'ur/ u0u/ psi& /&'* d&++

s&d&r-. P&+&ri/s 6r06riu+ 0id/ di'ur/ d ru di/u/ i di2uri*i d1

i9&/si. Psi& d&* dir&, +u0- d ***u /&s&i+* 2ir dp0 didu* 0&rdp0

***u +&06is+& /u0, s&-i** p&+&ri/s &&/0r6i0 dip&ru/. P&+&ri/s

r06riu+ i p&ru di/u/ u0u/ +&2ri p&1& 0i+u1 d&++. #

PENATALAKSANAAN

Ad 3 - 1* p&ru di/&r'/ pd p&0/s /&'* d&++ 1i0u:#,3,,8,?,>,%$

%. P&*60 9s& /u0

#. M&2ri d +&*60i p&1&

3. P&*60 pr69i/sis 0&r-dp &ru*1 /&'* d&++

Pengobaan !a"e a#$

Pd =/0u /&'* psi& di+iri*/ u0u/ +&2&*- spirsi ud- 0u +u0-

d dius-/ ' 9s -rus &s *r 6/si*&issi 0&r'+i. P&r-0i/ 0d ;i0 s&p&r0i

/&sdr, 0&/ dr-, su-u, p&r9s, d 9u*si '0u*. Su-u 0uu- 1* 0i**i

di0uru/ d&* /6+pr&s ir -*0 d p&+&ri 0ipir&0i/.

D&++ 1* 0i+u dp0 di0uru/ d&* 0ipir&0i/ 1i0u s&0+i69& %$ 7 %8

+*/*BB-ri s&0ip C ? '+ 0u iupr69& 8 C %$ +*/*BB-ri s&0ip C ? '+.

Di&p+ d- 60 1* pi* 2&p0 +&*-&0i/ /&'*. E9&/ 0&rp&u0i/

di&p+ s*0 2&p0, 1i0u 0r 3$ d&0i/ s+pi 8 +&i0 d &9&/ 06/si/ 1* s&rius -+pir

0id/ di'u+pi pi di&ri/ s&2r p&r- d d6sis 0id/ +&&i-i 8$ +* 0ip /i

su0i/. Di&p+ dp0 di&ri/ s&2r i0r;& d i0rr&20. D6sis di&p+ i0r;&

$,37$,8 +*/*BB/i d&* /&2&p0 %7# +*+&i0 d&* d6sis +/si+ #$ +*.

P&+&ri di&p+ s&2r i0r;& pd / 1* /&'* s&ri*/i +&1ui0/,

2r p&+&ri 1* +ud-, s&d&r- d &9&/0i9 +&ui r&/0u+ 0&- diu/0i/

/&+pu-1. P&+&ri di&p+ r&/0 di/u/ pd / d+ p6sisi +iri* 0u

+&u**i* d /&+udi r&/0i6 1* u'u*1 di6&si ;s&i, di+su// /& r&/0u+

9


10/24

s&d+ 3 7 8 2+. K&+udi r&/0i6 dipi'0 -i** /6s6* &0u d s&'u01 u0u/ &&rp

+&i0 u* duur di0u0up d&* 2r +&rp0/ /&du +us/uus *u0&us. D6sis di&p+

i0rr&20 1* dp0 di*u/ d- 8 +* u0u/ &r0 d /ur* dri %$ /* 0u %$ +*

u0u/ &r0 d &i- dri %$ /*. Bi /&'* 0id/ &r-&0i di&p+ dp0 diu* # /i *i

d&* i0&r; 8 +&i0, i 0id/ &r-&0i 'u* &ri/ 9&i06i d&* d6sis = %$7#$

+*/*BB s&2r i0r;& p&r-7- % +*/*BB+&i0. S&0&- p&+&ri 9&i06i, -rus

di/u/ p&+is d&* N5 9isi66*is /r& 9&i06i &rsi90 s d +&1&/

iri0si ;&.

Bi /&'* &r-&0i d&* di&p+, 'u0/ d&* p&+&ri 9&6ri0

i0r+us/ur. D6sis = u0u/ 1i % u C % 0-u 8$ +* d di 0s % 0-u d- 8

+*. Lu '+ /&+udi di&ri/ 9&6ri0 d6sis ru+0. U0u/ # -ri p&r0+ di&ri/

d6sis 47%$ +*/*BB-ri di*i d+ # d6sis, u0u/ -ri7-ri &ri/u01 d&* d6sis 78

+*/*BB-ri di*i # d6sis. D6sis +/si+ 9&6ri0 d- #$$ +*-ri /r& dp0

+&1&/ -ip60&si, p&uru /&sdr, d d&pr&si p&r9s.

Men%a&' an engoba' *en+ebab

P&+&ri/s 2ir s&r&r6spi di/u/ u0u/ +&1i*/ir/ /&+u*/i

+&i*i0is, 0&ru0+ pd psi& /&'* d&++ 1* p&r0+. Wupu d&+i/i /&1/

d6/0&r +&/u/ pu*si u+ -1 pd /sus 1* di2uri*i s&*i +&i*i0is, +is1

i d *&' +&i*i0is 0u i /&'* d&++ &r*su* +.#

P&o!'a#"'" $n$# en%ega- e&a'n+a #eang ea be&$ang

P&*60 ii di*i 0s # *i, 1i0u:#

%. Pr69i/sis i0&r+i0&

U0u/ +&2&*- 0&ru*1 /&'* /&+i di/&+udi -ri, p&d&ri0 1* +&d&ri0

/&'* d&++ s&d&r- di&ri/ di&p+ s&2r 6r u0u/ pr69i/sis i0&r+i0& d&*

d6sis $,37$,8 +*/*BB-ri di*i d+ 3 d6sis s0 psi& d&++. Di&p+ dp0 'u*

di&ri/ s&2r i0rr&20 0ip 4 '+ s&1/ 8 +* u0u/ &r0 d /ur* dri %$ /* d

%$ +* u0u/ &r0 d &i- dri %$/* s&0ip psi& +&u'u/ su-u &i- dri 34,8 5.

Pr69i/sis i0&r+i0& ii s&i/1 di&ri/ s+pi /&+u*/i / u0u/ +&d&ri0 /&'*

d&++ s&dr- s*0 /&2i, 1i0u s+pi s&/i0r u+ur 0-u.

#. Pr69i/sis '*/ p'*

10


11/24

Pr69i/sis '*/ p'* &r*u u0u/ +&'+i 0&rdp01 d6sis 0&rp&u0i/ 1*

s0i d 2u/up did+ dr- p&d&ri0 u0u/ +&2&*- &ru*1 /&'* d&++ 1*

dp0 +&1&/ /&rus/ 60/ 0&0pi 0id/ dp0 +&2&*- 0&r'di1 &pi&psi di/&+udi

-ri. Pr69i/sis '*/ p'* d&* 9&6ri0 78 +* /*BB-ri di*i d+ # d6sis. O0

i 1* dp0 di*u/ d- s+ ;pr60 d&* d6sis %87$ +*/*BB-ri. A0i/6;us

u0u/ pr69i/sis '*/ p'* di&ri/ s&+ %7# 0-u s&0&- /&'* 0&r/-ir d di-&0i/

&r0-p s&+ %7# u.

Pr69i/sis '*/ p'* dp0 dip&r0i+*/ i d # /ri0&ri (0&r+su/ p6i %0u #) 1i0u: #

. S&&u+ /&'* d&++ 1* p&r0+ sud- d /&i &ur66*is 0u

p&r/&+* (+is1 s&r&r psi 0u +i/r6s&9, r&0rdsi +&0).

. K&'* d&++ &i- + dri %8 +&i0, 96/, 0u dii/u0i /&i

&ur66*iss&+&0r 0u +&&0p.

2. Ad ri=10 /&'* 0p d&++ pd 6r* 0u 0u sudr /du*.

d. Bi /&'* d&++ 0&r'di pd 1i &ru+ur /ur* dri %# u 0u 0&r'di /&'*

+u0ip& d+ s0u &pis6d& d&++.

Bi -1 +&+&u-i s0u /ri0&ri s' d i*i +&+&ri/ p&*60 '*/

p'*, +/ &ri/ pr69i/sis i0&r+i0& 1i0u pd =/0u / d&++ d&* di&p+ 6r u

r&/0 0ip 4 '+ di s+pi* 0ipir&0i/

D+ p&* /&'* d&++, 6r* 0u -rus +&*up1/ diri s&0&* +u*/i

d+ +&*6s&r;si /. B&&rp - 1* -rus dip&r-0i/ d- s&*i &ri/u0 :4,>,%$

A/ -rus diri*/ di 0&+p0 1* d0r d&* p6sisi +&1+pi*, u/

0&r&0*, u0u/ +&*-idri -1 0&rs&d/.

* +&&0// &d ppu d+ +uu0 si / s&p&r0i s&d6/ 0u p&**ris,

/r& 'us0ru &d 0&rs&u0 dp0 +&1u+0 ' ps.

* +&+&**i / u0u/ +&= /&'*.

S&*i &sr /&'* &r*su* si*/0 d 0id/ +&+&ru/ p&* /-usus.

i/ /&'* 0&rus &r'u0 s&+ %$ +&i0, / -rus s&*&r di= /& 9sii0s

/&s&-0 0&rd&/0. Su+&r i +&*'ur/ / u0u/ di= /& 9sii0s /&s&-0 'i/

11


12/24

/&'* +si- &r'u0 s&0&- 8 +&i0. Ad pu su+&r 1* +&10/ -= p&*

&i- i/ di/u/ s&2&p0 +u*/i 0p +&10/ 0s +&i0.

S&0&- /&'* &r/-ir ('i/ F %$ +&i0), / p&ru di= +&&+ui d6/0&r u0u/

+&&i0i su+&r d&++, 0&ru0+ 'i/ d /&//u &-&r, +u0-7+u0- 1* &r0, 0u /

0&rus 0+p/ &+s.

i/ / di= /& 9sii0s /&s&-0, p&* 1* / di/u/ s&i p6i7p6i di 0s

d- s&*i &ri/u0 :4,>,%$

M&+s0i/ ' ps / 0id/ 0&rsu+0

P&+&ri 6/si*& +&uifa!e mas'

P&+&ri di&p+ $,8 +*/* &r0 d p&r r&/0 (+&ui us) 0u 'i/ 0&-

0&rps* s&* i9us $,# +*/* p&r i9us P&*=s 0d70d d&pr&si p&rps

S#ea 1. BAGAN PENG/ENTIAN KEJANG DEMAM

KEJANG

12


13/24

Di&p+ r&/0 $,8 +*/*BB 0u

B&r0 d F %$ /*: 8 +*

B&r0 d %$ /*: %$ +*, 0u Di&p+ I" $,37$,8 +*/*BB

KEJANGDi&p+ R&/0

Di ru+- s/i0

KEJANG

Di&p+ I"K&2&p0 $,87% +*+&i0 (378 +&i0)

(D&pr&si p&rps dp0 0&r'di)

KEJANG

!&i06i 6us I" %$7#$ +*/*BB

K&2&p0 $,87% +*/*BB+&i0

KEJANG

Trs9&r /& ru* r=0 i0&si9

eteran#an1& *i la 'e+ an# ber, en ti terai ro fil a'sis inter mite n atau rumatan $iberi' an ner$ asar'a n'e +an#$emam se$er,ana atau 'omle's $an fa'tor lainn%a- & Pe mb er i a n f e n i t o i n bo l u s se ba i ' n% a

s e ! a r a $ r i i n t r a " e n a $ i ! a m u r $ e n a # n ! a i r a n N a C l fisiolo#is. untu' men#uran#i efe' samin,

aritmia $an ,iotensi

PROGNOSIS0

D&* p&*u* 1* 0&p0 d 2&p0, pr6*6sis /&'* d&++ i/ d 0id/

+&1&/ /&+0i. !r&/u&si &ru*1 /&'* &r/isr 0r #8< 7 8$


14/24


15/24

0.1 IDENTIFIKASI PASIEN

N+ : D*

U+ur : # 0-u

&is K&+i : /i7/i

MR : $3>$3

0.0 ANAMNESIS

S&6r* psi& /i7/i &ru+ur # 0-u /iri+ dri IGD RSUD Ar6su/ +su/ /&

*s / 0** %? N6;&+&r #$% d&* :

Ke$-an Uaa

K&'* % '+ s&&u+ +su/ ru+- s/i0

R'a+a Pen+a#' Se#a&ang

K&'* % '+ s&&u+ +su/ ru+- s/i0, 9r&/u&si #, + /&'* 8 +&i0, /&'*

+&dd/ pd s&uru- 0uu-, +0 0&r&/, d /&ur ui- dri +uu0. S&&u+

/&'* psi& d&++ 0i**i. S&0&- /&'* psi& 0&r0idur..

D&++ s&'/ % -ri s&&u+ +su/ ru+- s/i0, d&++ +&dd/ 0i**i, 0&rus

+&&rus, 0id/ +&**i*i d 0id/ &r/&ri*0

B0u/ pi&/ 0id/ d

Ri=10 0ru+ 0id/ d

Bu* ir /&2i =r d 'u+- is

Bu* ir &sr =r d /6sis0&si is

R'a+a Pen+a#' Da-$$

A/ p&r- +&d&ri0 /&'* dis&r0i d&++ s&p&r0i ii s&&u+1 s0 &ru+ur >

u d %3 u, 9r&/u&si +si*7+si* #73, +1 %$ +&i0, dir=0 di

RSUD di = /&0i/ 6r*0u psi& +si- 0i** di s, d 0id/ ru0i &r60 0i

/&'*.

R'a+a Pen+a#' Ke$a&ga

15


16/24

Tid/ d **60 /&ur* psi& 1* +&d&ri0 /&'* s&p&r0i ii s&&u+1

R'a+a Kea-'&an

L-ir 6r+, 2u/up u, di066* 6&- id

S0 -ir +&*is /u0, &r0 d -ir #4$$ *r+, p'* d -ir 2+

R'a+a I$n'"a"'

B5G : u+ur % u, s2r () di &* / 0s

DPT : u+ur #, 3, u

P6i6 : u+ur #, 3, u

H&p0i0is B : u+ur #, 3, u

5+p/ : u+ur > u

K&s : I+uissi dsr &*/p

R'a+a Peebangan

P&r/&+* 9isi/ :

0&r0= : # u

+iri* : 3 u

0&*/urp : u

dudu/ : ? u

+&r*// : 4 u

&rdiri : %$ u

ri : %# u

*i*i p&r0+ : ? u

i2r s0u su/u /0 : %% u

p&r/&+* +&0:

isp '&+p6 (7), *i*i0 /u/u (7), +&*6+p6 (7), /0i9 s&/i (7), p0i (7), /&0/u0 (7), p&r*u

'&&/ (7)

/&s : p&r/&+* 9isi/ d +&0 i/

R'a+a So"'a E#ono'

Psi& / /& # dri # &rsudr

16


17/24

R'a+a Pe&$a-an an L'ng#$ngan

Ru+- p&r+&

Su+&r ir +iu+ dri ir isi u* (*6)

+ di d+ ru+-

P&/r* 2u/up us

S+p- diu* /& 0&+p0 p&+u* s+p- u+u+

K&s -i*i&& d si0si i/

0.2 PEMERIKSAAN FISIK

K&d u+u+ : s/i0 s&d* K&sdr : s6+6&!r&/u&si 9s : 3$ +&i0 Ndi : %%?+&i0

Su-u : 3>5

B&r0 d : %$ /* Ti**i d : 48 2+

Si6sis : Tid/ d BBU : 43

porto folio 1

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