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"Latar belakang : Reaksi simpang yang terjadi akibat penggunaan OAE berpengaruh terhadap kualitas hidup pasien epilepsi. Angka kejadian reaksi simpang akibat penggunaan OAE dilaporkan mencapai 80%. Sampai saat ini belum didapatkan studi atau instrumen yang valid dalam menilai reaksi simpang pada penggunaan OAE di Indonesia. Tujuan dari studi ini adalah melakukan validasi terhadap kuesioner Liverpool Adverse Events Profile (LAEP) versi bahasa Indonesia dan mendapatkan prevalensi reaksi simpang serta faktor yang berpengaruh. Metode penelitian : Dilakukan studi observasional potong lintang pada pasien epilepsi dengan dosis OAE yang stabil di poliklinik epilepsi rumah sakit Cipto Mangunkusumo. Kuesioner diterjemahkan dari versi bahasa Inggris ke bahasa Indonesia dan dilakukan penerjemahan kembali ke bahasa aslinya untuk menilai ketepatan dari bahasa. Validitas dan reliabilitas diuji dengan menggunakan koefisien korelasi Spearman dan cronbach's alpha. Faktor yang dianalisis adalah durasi epilepsi, onset epilepsi, frekuensi bangkitan, tipe epilepsi, etiologi epilepsi, sindrom epilepsi, jumlah OAE, durasi OAE dan komorbiditas. Hasil : Didapatkan 19 variabel pertanyaan yang valid dengan rentang koefisien korelasi 0,465 sampai 0,690. Cronbach?s alpha 0,846. Prevalensi reaksi simpang pada pasien epilepsi yaitu 91%. Reaksi simpang yang sering terjadi adalah kelelahan (67,8%), mengantuk (66,7%), gangguan daya ingat (62,2%) dan kesulitan berkonsentrasi (56,7%). Variabel klinis yang berpengaruh terhadap kejadian reaksi simpang yaitu politerapi (p=0.022). Kesimpulan : Kuesioner Liverpool Adverse Events Profile versi bahasa Indonesia merupakan instrumen yang valid dan reliabel dalam menilai reaksi simpang pada penggunaan OAE pada pasien epilepsi. Politerapi merupakan faktor yang berpengaruh terhadap kejadian reaksi simpang.

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Background : Adverse effects (AE) of antiepileptic drugs (AEDs) affect the quality of life of patients with epilepsy. The prevalence of AE of AEDs in patients with epilepsy is up to 80%. There are no studies nor validated instruments in measuring AE of AEDs in patients with epilepsy in Indonesia. This study aimed to validate the Indonesian version of The Liverpool Adverse Events Profile (LAEP) also to determine the prevalence of AE of AEDs in patients with epilepsy and related factors.

Methods : An observational cross-sectional study was carried out on epilepsy outpatients clinic in Cipto Mangunkusumo Hospital. Patient treated with a stable dose of AED were enrolled. The questionnaire was translated from the English version into Indonesian version and then was back-translated to examine its accuracy. The validity and reliability was tested by Spearman correlation coefficient and cronbach?s alpha. The Indonesian version of LAEP was selfadministered by the patient. The analyzed factors consisted of epilepsy duration, onset of epilepsy, seizure frequency, type of epilepsy, etiology and epilepsy syndrome, number of AEDs, AEDs duration and comorbidity.

Results : All of the 19 variable of questions were valid, with range of correlation coefficient from 0.465 to 0.690. The cronbach?s alpha was 0.846. Ninety patients were enrolled. The prevalence of AE of AEDs in patients with epilepsy was 91%. The most common AE were tiredness (67.8%), sleepiness (66.7%), memory problems (62.2%) and difficulty in concentrating (56.7%). Clinical variables that influenced the AE was polytherapy.

Conclusion : The Indonesian version of the Liverpool Adverse Events Profile is a valid and reliable instrument in assessing AE of AEDs in patients with epilepsy. Almost all of the patients in this study experienced an AE. Polytherapy was the related factors of AE of AEDs."

"Latar Belakang. Pasien epilepsi memerlukan obat antiepilepsi (OAE) dalam waktu lama, minimal 1-2 tahun.OAE yang terbanyak digunakan di Indonesi adalah OAE generasi lama yaitu karbamazepin, fenitoin, fenobarbital, dan valproat.Karbamazepin, fenitoin, dan fenobarbital dapat menyebabkan stres oksidatif dan peningkatan kolesterol sedangkan menyebabkan resistensi insulin.Keempat OAE dapat menyebabkan peningkatan homosistein. Hal tersebut dapat menyebabkan disfungsi endotel yang merupakan awal dari aterosklerosis.Ketebalan kompleks intima-media (KIM) karotis komunis dapat digunakan sebagai indikator dari aterosklerosis.Oleh karena itu diperlukan pengukuran ketebalan KIM karotis komunis pada pasien epilepsi yang menggunakan OAE generasi lama untuk deteksi awal aterosklerosis. Metode penelitian. Penelitian ini menggunakan desain potong lintang untuk melihat perbandingan ketebalan KIM karotis komunis kelompok studi (pasien epilepsi) dengan kelompok kontrol (populasi normal) dengan usia dan jenis kelamin yang disesuaikan. Variabel independen adalah usia, jenis kelamin, jumlah OAE, jenis OAE, dan durasi OAE. Hasil. Didapatkan sampel masing-masing 46 subjek kelompok studi dan kontrol. Median ketebalan KIM karotis komunis kelompok studi (0,49 (0,36-1,40) mm) lebih dari kontrol (0,43 (0,35-0,77) mm) secara bermakna. Pada penelitian ini tidak didapatkan hubungan antara usia, jenis kelamin, jumlah OAE, jenis OAE, durasi OAE dengan ketebalan KIM karotis komunis pada pasien epilepsi. Kesimpulan. Ketebalan KIM karotis komunis pasien epilepsi yang menggunakan OAE generasi lama lebih tebal dari kelompok kontrol.

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Background. Epilepsy patients requires long-term antiepileptic drugs (AEDs) at least for 1-2 years. The most common AEDs used in Indonesia are first generation AEDs which are carbamazepine (CBZ), phenytoin (PHT), phenobarbital (PB), and valproate (VPA). The first three AEDs may cause oxidative stress and increased cholesterol level while VPA causes insulin resistance. All AEDs cause increased homocysteine level. All those factors could cause endothelial dysfunction which is known as initial process in atherosclerosis. Common carotid intima-media thickness (CC IMT) is a well-known indicator of atherosclerosis. Therefore CC IMT measurement on epilepsy patients with old generation AEDs is required for early detection of atherosclerosis.

Methods. This was a cross-sectional study that comparing CC IMT of epilepsy patients and control group (normal subjects) with age and sex matched. The independent variables were age, sex, number of AEDs, type of AEDs, and duration of AEDs.

Results. There were 46 subjects for each group. The CC IMT median of epilepsy patients (0,49 (0,36-1,40) mm) were significantly thicker than control group (0,43 (0,35-0,77) mm). There were no association of age, sex, number of AEDS, type of AEDs, duration of AEDs with CC IMT.

Conclusions. CC IMT of epilepsy patients with first generation AEDs was higher than control group."

"Penghentian obat antiepilepsi OAE dengan terburu-buru meningkatkan risiko relaps pada epilepsi. Risiko resistensi obat pada epilepsi relaps sangat tinggi. Belum ada kesepakatan umum kapan OAE dapat dihentikan dengan aman sehingga tidak terjadi relaps. Penelitian ini bertujuan untuk mengetahui angka kejadian relaps pada anak dengan epilepsi terkontrol danyang belum terkontrol kejangnya, mengetahui karakteristik anak dengan epilepsi terkontrol yang mengalami relaps, mengetahui faktor prediktor epilepsi relaps, mengetahui luaranepilepsi relaps, mengetahui perjalanan EEG anak dengan epilepsi relaps. Penelitian dilakukan pada Juni-Desember 2016. Desain studi adalah kasus-kontrol, retrospektif, multisite dari rekam medis tahun 2012-2016. Studi rekam medis dilanjutkan dengan wawancara dan pemeriksaan EEG untuk kelompok kasus. Kelompok kasus adalah anak-anak dengan epilepsi relaps sedangkan kelompok kontrol adalah epilepsi remisi komplit. Analisis bivariat dan multivariat dilakukan untuk mengidentifikasi faktor prediktor epilepsi relaps. Angka kejadian epilepsi relaps pada penelitian ini adalah 13,6 . Dilakukan analisis terhadap 63 subyek epilepsi relaps dan 63 subyek epilepsi remisi komplit. Faktor prediktor epilepsi relaps pada analisis bivariat yaitu: epilepsi simptomatik P

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An inappropriate antiepileptic drugs AED withdrawal increases the risk of relapse. The risk of drug resistance in epilepsy relapse is very high. There is no consensus when the AED is safely withdrawn, so that epilepsy will not relapse. This study aims to know the incidence of relapse in children with controlled and uncontrolled epilepsy, the characteristics, predictors, outcomes, and EEG evolutions in children with epilepsy relapse. This study was held from June December 2016. This was a case control study with retrospective, multi site medical record evaluation from 2012 2016, followed by interview and EEG examination for the case group. The case group was children with epilepsy relapse, while the control was children with epilepsy complete remission. Bivariate and multivariate analysis was done to identify predictors of relapse. The incidence of epilepsy relapse in this study was 13,6 . We analyzed 63 epilepsy relapse and 63 epilepsy complete remission subjects. Relapse predictors in bivariate analysis were symptomatic etiology P"

"Golongan obat antikonvulsan memerlukan perhatian khusus untuk dipantau karena tingkat konsekuensi kegagalan terapi yang tinggi dan beberapa obat memiliki indeks terapi sempit. Obat indeks terapi sempit dapat menimbulkan masalah terkait obat yang terdiri dari efektivitas pengobatan, efek samping obat, dan biaya pengobatan. Tujuan dari penelitian ini adalah untuk melakukan monitoring efek samping pada pasien epilepsi yang mendapatkan karbamazepin, fenitoin, asam valproat, atau kombinasi obat-obat tersebut di Instalasi Rawat Jalan RSUP Fatmawati periode Maret-Mei 2017. Penelitian ini merupakan penelitian deskriptif analitik yang dilakukan secara prospektif pada pasien dewasa yang memenuhi kriteria inklusi secara total sampling. Data didapatkan dari data primer yang berasal dari hasil wawancara dan data sekunder yang berasal dari rekam medis. Data yang terkumpul dianalisis menggunakan Algoritma Naranjo. Subjek penelitian yang didapatkan sebanyak 54 pasien dengan 38 pasien 70,37 mengalami efek samping dan 16 pasien 29,63 tidak mengalami efek samping. Kategori efek samping yang paling banyak ditemukan adalah probable dengan persentase 48,15. Tidak ada hubungan antara usia p=0,903 dan jenis kelamin p=1,000 dengan efek samping yang terjadi.

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Anticonvulsant drugs must get special attention to be monitored due to the concequence's rate that they have. This group comprises of some drugs which have narrow therapeutic index. Thus, the group causes drug related problem, such as therapeutic efficiency, drug side effect, and cost of the treatment. The purpose of this research was to monitor drug side effects that were severed by adult patients of epilepsy who got carbamazepine, or phenytoin, or valproic acid, or combination of the drugs at Outpatient Department, Fatmawati Central General Hospital from March to May 2017. The research was running prospectively and the data were collected from patients who fit to inclusion criteria with total sampling. There were 54 patients selected as samples, 38 patients 70.37 experienced drugs side effects and 16 patients 26.93 didn't experience drugs side effects. The data of patients were from primer data's source that is the answer of interview and secondary data's source that is medical record that were analyzed with Naranjo Algorithm. The most drug side effect category that found is probable with percentage 53.70 . Age p 0.903 and gender p 1.000 didn't have correlation with the rising of side effects."

"ABSTRAK Latar Belakang. Gangguan cemas menyeluruh (GCM) merupakan salah satu bentuk gangguan ansietas tersering pada populasi epilepsi yang dapat menurunkan kualitas hidup, sehingga deteksi dini sangatlah penting. Generalized Anxiety Disorder-7 (GAD-7) merupakan instrumen penapis GCM satu-satunya yang pernah divalidasi pada pasien epilepsi, yaitu di Korea dengan titik potong ≥7. Instrumen GAD-7 dapat dikerjakan pasien sendiri kurang dari 3 menit, sehingga cocok digunakan di poliklinik neurologi. Penelitian ini bertujuan untuk mendapatkan kuesioner GAD-7 versi bahasa Indonesia yang valid, reliabel dan akurat untuk menapis GCM pada pasien epilepsi dewasa.Metode Penelitian. Penelitian dibagi menjadi 2 tahap. Tahap pertama meliputi adaptasi lintas budaya berdasarkan ketentuan World Health Organization (WHO), uji validitas isi berdasarkan penilaian pakar mengenai relevansi butir pertanyaan GAD-7 hasil adaptasi, dilanjutkan uji validitas interna, reliabilitas interna dan reliabilitas test-retest pada 30 pasien epilepsi yang memenuhi kriteria inklusi. Tahap kedua adalah uji diagnostik. Hasil GAD-7 dengan titik potong ≥7 dibandingkan dengan wawancara Mini International Neuropsychiatric Interview International Classification of Diseases-10 (MINI ICD-10) sebagai baku emas.Hasil. Koefisien validitas isi berdasarkan metode Martuzua dari GAD-7 hasil adaptasi bahasa Indonesia adalah 0,847. Hasil uji validitas interna dengan korelasi Spearman didapatkan koefisien korelasi 0,648 hingga 0,800 (p<0,01). Uji reliabilitas konsistensi interna dengan Cronbach?s Alpha 0,867. Perbedaan nilai koefisien korelasi dan Cronbach?s Alpha antara pemeriksaan pertama dan retest menunjukkan reliabilitas test-retest yang baik. Dari 146 subyek uji diagnostik, prevalensi GCM hasil pemeriksaan MINI ICD-10 sebesar 16,4%. Dengan titik potong ≥7, GAD-7 memiliki sensitivitas 100% dan spesifisitas 84,4%. Kesimpulan. Kuesioner GAD-7 versi Indonesia terbukti valid dan reliabel sehingga dapat digunakan untuk menapis GCM. Dengan titik potong ≥7, GAD-7 memiliki nilai akurasi yang tinggi untuk menapis GCM pada pasien epilepsi dewasa.ABSTRACT Background. Generalized anxiety disorder (GAD) is one of the most common type among anxiety disorders in epilepsy population that can impaired patients quality of life. The Generalized Anxiety Disorder-7 (GAD-7) is a screening tool for detecting GAD that has been validated in epilepsy patients in Korea with cut-off point ≥7. The GAD-7 could be filled by the patients themselves in less than three minutes; hence, it is appropriate to be used in the neurology outpatient setting. The objective of this study is to obtain a valid, reliable, and accurate GAD-7 in Indonesian language as a screening tool of GAD in adult epilepsy patients.Method. The study was conducted in two phases. The first phase included transcultural adaptation based on World Health Organization standards, content validity test based on expert consideration regarding the relevance of GAD-7 question items, followed by internal validity test, internal reliability test and test-retest in 30 epilepsy patients. The second phase was diagnostic test, in which, the GAD-7 with cut off point ≥7 will be compared with Mini International Neuropsychiatric Interview International Classification of Diseases-10 (MINI ICD-10) as the gold standard examination for diagnosing GAD.Results. Content validity coefficient of GAD-7 adapted version based on Martuzua method was 0.847. Internal validity test with Spearman correlation obtained the correlation coefficient 0.648 to 0.800 (p< 0.01). Internal consistency reliability test with Cronbach?s Alpha was 0.867. The difference of correlation coefficient and Cronbach?s Alpha between the first and the retest showed good test-retest reliability. Out of 146 subjects of diagnostic test, the prevalence of GAD using MINI ICD-10 was 16.4%. With cut off point >7, GAD-7 had sensitivity 100% and specificity 84.4%.Conclusion. The Indonesian version of the the GAD-7 was proven to be valid and reliable, also was found to be accurate as a screening tool for GAD in adult epilepsy patient with cut off point ≥7.;Background. Generalized anxiety disorder (GAD) is one of the most common type among anxiety disorders in epilepsy population that can impaired patients quality of life. The Generalized Anxiety Disorder-7 (GAD-7) is a screening tool for detecting GAD that has been validated in epilepsy patients in Korea with cut-off point ≥7. The GAD-7 could be filled by the patients themselves in less than three minutes; hence, it is appropriate to be used in the neurology outpatient setting. The objective of this study is to obtain a valid, reliable, and accurate GAD-7 in Indonesian language as a screening tool of GAD in adult epilepsy patients.Method. The study was conducted in two phases. The first phase included transcultural adaptation based on World Health Organization standards, content validity test based on expert consideration regarding the relevance of GAD-7 question items, followed by internal validity test, internal reliability test and test-retest in 30 epilepsy patients. The second phase was diagnostic test, in which, the GAD-7 with cut off point ≥7 will be compared with Mini International Neuropsychiatric Interview International Classification of Diseases-10 (MINI ICD-10) as the gold standard examination for diagnosing GAD.Results. Content validity coefficient of GAD-7 adapted version based on Martuzua method was 0.847. Internal validity test with Spearman correlation obtained the correlation coefficient 0.648 to 0.800 (p< 0.01). Internal consistency reliability test with Cronbach?s Alpha was 0.867. The difference of correlation coefficient and Cronbach?s Alpha between the first and the retest showed good test-retest reliability. Out of 146 subjects of diagnostic test, the prevalence of GAD using MINI ICD-10 was 16.4%. With cut off point >7, GAD-7 had sensitivity 100% and specificity 84.4%.Conclusion. The Indonesian version of the the GAD-7 was proven to be valid and reliable, also was found to be accurate as a screening tool for GAD in adult epilepsy patient with cut off point ≥7.;Background. Generalized anxiety disorder (GAD) is one of the most common type among anxiety disorders in epilepsy population that can impaired patients quality of life. The Generalized Anxiety Disorder-7 (GAD-7) is a screening tool for detecting GAD that has been validated in epilepsy patients in Korea with cut-off point ≥7. The GAD-7 could be filled by the patients themselves in less than three minutes; hence, it is appropriate to be used in the neurology outpatient setting. The objective of this study is to obtain a valid, reliable, and accurate GAD-7 in Indonesian language as a screening tool of GAD in adult epilepsy patients.Method. The study was conducted in two phases. The first phase included transcultural adaptation based on World Health Organization standards, content validity test based on expert consideration regarding the relevance of GAD-7 question items, followed by internal validity test, internal reliability test and test-retest in 30 epilepsy patients. The second phase was diagnostic test, in which, the GAD-7 with cut off point ≥7 will be compared with Mini International Neuropsychiatric Interview International Classification of Diseases-10 (MINI ICD-10) as the gold standard examination for diagnosing GAD.Results. Content validity coefficient of GAD-7 adapted version based on Martuzua method was 0.847. Internal validity test with Spearman correlation obtained the correlation coefficient 0.648 to 0.800 (p< 0.01). Internal consistency reliability test with Cronbach?s Alpha was 0.867. The difference of correlation coefficient and Cronbach?s Alpha between the first and the retest showed good test-retest reliability. Out of 146 subjects of diagnostic test, the prevalence of GAD using MINI ICD-10 was 16.4%. With cut off point >7, GAD-7 had sensitivity 100% and specificity 84.4%.Conclusion. The Indonesian version of the the GAD-7 was proven to be valid and reliable, also was found to be accurate as a screening tool for GAD in adult epilepsy patient with cut off point ≥7.;Background. Generalized anxiety disorder (GAD) is one of the most common type among anxiety disorders in epilepsy population that can impaired patients quality of life. The Generalized Anxiety Disorder-7 (GAD-7) is a screening tool for detecting GAD that has been validated in epilepsy patients in Korea with cut-off point ≥7. The GAD-7 could be filled by the patients themselves in less than three minutes; hence, it is appropriate to be used in the neurology outpatient setting. The objective of this study is to obtain a valid, reliable, and accurate GAD-7 in Indonesian language as a screening tool of GAD in adult epilepsy patients.Method. The study was conducted in two phases. The first phase included transcultural adaptation based on World Health Organization standards, content validity test based on expert consideration regarding the relevance of GAD-7 question items, followed by internal validity test, internal reliability test and test-retest in 30 epilepsy patients. The second phase was diagnostic test, in which, the GAD-7 with cut off point ≥7 will be compared with Mini International Neuropsychiatric Interview International Classification of Diseases-10 (MINI ICD-10) as the gold standard examination for diagnosing GAD.Results. Content validity coefficient of GAD-7 adapted version based on Martuzua method was 0.847. Internal validity test with Spearman correlation obtained the correlation coefficient 0.648 to 0.800 (p< 0.01). Internal consistency reliability test with Cronbach?s Alpha was 0.867. The difference of correlation coefficient and Cronbach?s Alpha between the first and the retest showed good test-retest reliability. Out of 146 subjects of diagnostic test, the prevalence of GAD using MINI ICD-10 was 16.4%. With cut off point >7, GAD-7 had sensitivity 100% and specificity 84.4%.Conclusion. The Indonesian version of the the GAD-7 was proven to be valid and reliable, also was found to be accurate as a screening tool for GAD in adult epilepsy patient with cut off point ≥7."

"Latar belakang. Epilepsi fokal merupakan jenis epilepsi terbanyak pada anak. Kemungkinan untuk terjadinya epilepsi intraktabel pada epilepsi fokal lebih besar dibandingkan dengan epilepsi umum. Data mengenai faktor risiko epilepsi fokal intraktabel masih sangat sedikit. Perlu dilakukan penelitian lebih lanjut untuk mengetahui strategi pengobatan dan konseling bagi pasien dan keluarga. Tujuan. (1) mendapatkan frekuensi terjadinya epilepsi intraktabel pada anak dengan epilepsi fokal. (2) mengetahui karakteristik pasien epilepsi fokal yang kontrol ke poliklinik Neurologi Anak. (3) mengetahui apakah usia awitan, etiologi epilepsi, frekuensi awal serangan, status perkembangan motor kasar awal, respon terapi awal, gambaran EEG awal, dan gambaran CT-Scan/MRI kepala dapat memprediksi kemungkinan terjadinya epilepsi intraktabel pada pasien anak dengan epilepsi fokal. (4) mengetahui apakah evolusi status perkembangan motor kasar, dan evolusi EEG epileptiform dapat memprediksi terjadinya epilepsi intraktabel. Metode penelitian. Desain penelitian adalah kohort retrospektif dan dilakukan poliklinik rawat jalan Neurologi Anak di RSCM sejak November 2013 sampai dengan Februari 2014 terhadap anak epilepsi fokal hingga usia 18 tahun, dengan lama pengobatan minimal 6 bulan. Faktor risiko dianalisis bivariat dan multivariat. Hasil penelitian. Angka kejadian epilepsi fokal intraktabel adalah 35 (39%).Usia subjek terbanyak adalah usia>3 tahun sebanyak 81(90%) subjek. Pada analisis bivariat didapat faktor risiko bermakna adalah etiologi kejang simtomatik (OR 6,12 IK95% 2,08-18,04), frekuensi kejang>5x/hari (OR 3,91 IK95% 1,43-10,75), respon awal terapi buruk (OR 233,14 IK95% 27,40-1983,27), EEG awal abnormal (OR 4,51 IK95% 1,82-11,17), MRI abnormal (OR 10,38 IK95% 2,91-37,06), evolusi status perkembangan motor kasar buruk (OR 21,62 IK95% 2,62-178,1), dan evolusi EEG epileptiform buruk (OR 25 IK95% 7,71-81,03). Pada analisis multivariat didapatkan respon awal terapi buruk dengan nilai OR136,00 (IK95% 14,79 sampai 1250,08), dan evolusi EEG epileptiform buruk dengan nilai OR 10,00 (1,68 sampai 59,35) merupakan faktor risiko yang berperan untuk menjadi epilepsi fokal intraktabel. Simpulan. Angka kejadian epilepsi fokal intraktabel sebanyak 39%. Faktor risiko yang berperan adalah respon terapi awal buruk, dan evolusi EEG epileptiform buruk.

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Background. Epilepsy focal is the most common type epilepsy in children. The chance to be intractable epilepsy is higher than general epilepsy. Therefore, study of the risk factors to predict intractable epilepsy is the utmost importance to conduct the treatment strategy and consult the patients and family.

Objective. (1) to determine the characteristic focal epilepsy in children (2) to determine the frequency of intractable focal epilepsy (3) to identify and analyze the association of early risk factors including the onset of seizure, frequency of seizure, etiology of epilepsy, gross motor developmental status, the response of antiepileptic drugs, the electroencephalogram (EEG), and magnetic resonance imaging (MRI) / computed tomography (CT) Scan findings with intractable focal epilepsy, (4) to identify and analyze the relationship between the evolution factors including the evolution of EEG epileptiform, and the evolution of gross motor development with intractable focal epilepsy.

Methods. Retrospective cohort study was conducted in child neurology outpatient clinics in Cipto Mangunkusumo Hospital Jakarta on November 2013 to February 2014. Inclusion criteria was children with epilepsy focal who was treated with antiepileptic drugs at least 6 month therapy until 18 years old age. Patients with febrile convulsions; central nervous system infections; neurodegenerative, neurometabolic diseases; and catastrophic epileptic syndromes with poor prognosis were excluded from the study. Data were analyzed using the IBM SPSS for Windowsv.17 software (IBM, New York, USA).

Results. The proportion of intractable focal epilepsy is 35 (39%). The most of children is >3 years old 81 (90%). Bivariate analysis showed that significantly early risk factors are symptomatic epileptic (OR = 6.12; 95%CI 2.08-18.04), frequency of seizure >5x/day (OR = 3.91; 95%CI 1.43-10,75), gross motor developmental delay (OR = 233.14; 95%CI 27.40-1983.27), early abnormal EEG wave (OR = 4.51; 95%CI 1.82-11.17), abnormal MRI (OR = 10.38; 95%CI 2.91-37.06), poor gross motor developmental evolution (OR = 21.62; 95%CI 2.62-178.1), and poor the EEG epileptiform evolution (OR = 25; 95%CI 7.71-81.03). Multivariate logistic regression analysis revealed that an initial non response to antiepileptic drugs (OR = 136.00; 95%CI 14.79-1250.08), and the poor evolution of EEG epileptiform (OR =10.00; 95%CI 1.68-59.35) were all found to be significant and independent risk factors for intractable focal epilepsy.

Conclusion. The present study reveals that the early non response to antiepileptic drugs, and poor of EEG epileptiform evolution are strongly associated with intractable focal epilepsy."

"ECVT adalah salah satu metode pencitraan kapasitansi volumetrik yang dapat menghasilkan citra 3D dari daerah yang dilingkupi oleh sensor kapasitansi. Metode ini digunakan dalam penelitian untuk mengetahui aktifitas kelistrikan otak pada penderita epilepsi dan pasien normal. Pasien diperiksa menggunakan EEG untuk mengetahui normal/abnormalitas pasien dan posisi abnormalitas yang menunjukkan gelombang epileptiform. Setelah diperiksa EEG, pasien diperiksa kembali menggunakan ECVT. Citra kepala hasil pemeriksaan ECVT diolah menjadi citra irisan aksial, sagital, dan koronal. Citra tiap pasien dianalisa untuk mengetahui karakteristik aktifitas listrik otak pasien normal dan pasien epilepsi. Citra aktifitas listrik otak pasien normal menunjukkan adanya pola yang seragam satu sama lain, tampak aktifitas listrik otak yang tinggi homogen dan kontinu pada daerah korteks. Sedangkan citra aktifitas listrik otak pasien epilepsi menunjukkan perbedaan pasien satu dengan yang lain dengan aktifitas listrik korteks tidak kontinu dan tidak homogen. Pada daerah abnormalitas menunjukkan aktifitas listrik otak yang lebih tinggi akibat lepasan muatan sedangkan pada daerah yang sama untuk pasien normal tidak menunjukkan adanya aktifitas listrik otak.

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ECVT is a methode that used to measure volumetric capacitance that could generate 3D images of the enclosed region with capacitance sensor. This methode is used for this research to study brain electric activity of epilepsy patient and normal patient. Patients were examined using EEG to get information about normal/abnormal of the patient and abnormality position which show epileptiform wave and then examined using ECVT. Brain electric activity image from ECVT examination was viewed as axial, sagital, coronal slices. Each brain electric activity patient's image was analyzed to understand charactheristic of normal brain electric activity and epilepsy patient. Brain electric activity of normal patients image shows a similar uniform distribution of high brain electric activity, homogen and continue around cortex. Brain electric activity of epilepsy patient image shows difference one and each other with brain electric activity is heterogen. Abnormality region of brain electric activity epilepsy patient shows activity which is not shown in the normal patient's brain."

"Epilepsi merupakan serangan sesaat yang disebabkan oleh aktivitas neuronal yang berlebihan dan menghasilkan infuls listrik yang tidak normal. Epilepsi memberikan dampak terhadap beberapa aspek, yaitu aspek kesehatan fisik, aspek psikologis, aspek sosial, dan aspek lingkungan. Tujuan penelitian ini adalah untuk mengetahui pengaruh edukasi manajemen epilepsi terhadap perubahan kualitas hidup pasien. Metode penelitian ini adalah quasy eksperiment. Sebanyak 86 pasien epilepsi yang melakukan kunjungan ke poliklinik saraf RS. Haji Jakarta yang dipilih menggunakan teknik purposive sampling. Hasil penelitian menunjukkan bahwa ada pengaruh yang signifikan antara edukasi manajemen epilepsi dibandingkan edukasi epilepsi standar rumah sakit dalam meningkatkan kualitas hidup epilepsi (p=0,035). Faktor-faktor yang berhubungan dengan kualitas hidup pasien epilepsi adalah tingkat pendidikan (p=0,001), pekerjaan (p=0,003), dan frekuensi bangkitan (p=0,022). Hasil analisis multivariat menunjukkan faktor yang paling dominan berhubungan dengan kualitas hidup pasien epilepsi adalah tingkat pendidikan (p=0,000; R=0,520; R² =0,270). Penelitian ini diharapkan dapat menjadikan video edukasi manajemen epilepsi sebagai standar intervensi asuhan keperawatan pada pasien dengan epilepsi.

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Epilepsy is a transient occurrence of signs or symptoms caused by abnormal neuronal activity or abnormal synchronization in the brain. The existence of epilepsy will have an impact on several aspects of life, namely the medical aspects, psychological aspects, social aspects, and environmental aspects. This impact will affect changes in the quality of life.

The aim of this study was to determine the effect of epilepsy management education on changes in the quality of life of epilepsy patients. This study was a quasy experiment method. A total of 86 epilepsy patients who visited the nerve polyclinic Jakarta Haji Hospital were selected by purposive sampling technique.

The results showed that there was a significant effect between epilepsy management education compared to hospital standard epilepsy education in improving the quality of life of epilepsy (p = 0.035). Factors related to the quality of life of epilepsy patients were the level of education (p = 0.001), employment (p = 0.003), and frequency of seizures (p = 0.022).

The results of multivariate analysis showed that the most dominant factor related to the quality of life of epilepsy patients was the level of education (p = 0,000; R = 0,520; R2 = 0,270). This study is expected to make epilepsy management education videos the standard of nursing care interventions in patients with epilepsy."

"Latar belakang. Gangguan perilaku pada anak epilepsi memiliki prevalens yang tinggi dan dapat menyebabkan dampak psikososial pada anak. Namun sejauh ini di Indonesia belum terdapat studi yang meneliti gangguan perilaku pada anak epilepsi serta faktor-faktor yang berhubungan. Tujuan. Penelitian ini untuk mengetahui: (1) proporsi dan jenis gangguan perilaku pada anak epilepsi berdasarkan child behavior checklist (CBCL), (2) hubungan antara: usia awitan kejang, frekuensi kejang, durasi epilepsi, obat anti epilepsi, tingkat sosial ekonomi, dan pendidikan orangtua, dengan gangguan perilaku pada anak epilepsi, (3) adaptasi keluarga dalam menghadapi anak epilepsi. Metode. Penelitian potong lintang di Klinik Neurologi Anak FKUI RSCM. Skrining gangguan perilaku dengan kuesioner CBCL dilakukan pada 30 anak epilepsi tanpa defisit neurologis dan disabilitas intelektual. Studi kualitatif untuk menilai adaptasi keluarga dalam menghadapi anak epilepsi. Hasil. Terdapat tiga dari tiga puluh anak epilepsi yang mengalami gangguan perilaku, dengan jenis gangguan perilaku eksternalisasi (perilaku melanggar aturan dan agresif), masalah sosial dan gangguan pemusatan perhatian. Faktor usia awitan kejang (p=0,280), frekuensi kejang (p=0,007; RP 0,036; IK95% 0,005-0,245), durasi epilepsi (p=1,000), obat anti epilepsi (p=0,020; RP 0,019; IK95% 0,001-0,437), tingkat sosial ekonomi (p=0,251), dan pendidikan orangtua (p=1,000), tidak berisiko meningkatkan gangguan perilaku. Terdapat sikap dan reaksi, serta persepsi dan stigma orangtua yang negatif dalam menghadapi anak epilepsi yang mengalami gangguan perilaku. Terdapat masalah keluarga sejak anak mengalami epilepsi dan gangguan perilaku. Orangtua tidak dapat menerapkan pola asuh displin dan kemandirian pada anak dengan gangguan perilaku. Simpulan. Proporsi gangguan perilaku pada anak epilepsi tanpa defisit neurologis dan disabilitas intelektual tidak tinggi. Tidak terdapat faktor-faktor yang memengaruhi gangguan perilaku. Adaptasi keluarga baik dalam menghadapi anak epilepsi tanpa gangguan perilaku, dibandingkan dengan keluarga anak epilepsi yang mengalami gangguan perilaku.

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Background. Behavior problems are prevalent in children with epilepsy and have psychosocial impact in children. However, in Indonesia, no research has ever been done to study behavior problems in children with epilepsy and related factors.

Objectives. This study aimed to define: (1) proportion behavior problem and type of behavior disorder based on child behavior checklist (CBCL), (2) the relationship between factors: age at seizure onset, seizure frequency, epilepsy duration, antiepileptic drug, socio-economic, and parents education, with behavior problems in epileptic children, (3) family adaptation on managing children with epilepsy.

Method. A Cross sectional study in Pediatric Neurology Clinic FKUI RSCM. Screening for behavior problems with CBCL questionnaires in 30 children with epilepsy without neurologic deficit and intellectual disability. A qualitative study examined family adaptation on managing children with epilepsy.

Results. There were three of thirty children with epilepsy, who have behavior problems, with externalizing disorder (delinquent and agressive behavior), social and attention problems. Age at seizure onset (p=0,280), seizure frequency (p=0,007; PR 0,036; CI95% 0,005-0,245), epilepsy duration (p=1,000), anti epileptic drug (p=0,020; PR 0,019; CI95% 0,001-0,437), socio-economic (p=0,251), dan parents education (p=1,000), are not risk factors for development of behavior problems. Parents’ behavior and reaction, their perception and stigma are negative on managing children with epilepsy and behavior problems. There are family problems since their children have epilepsy and behavior problems. Parents are unable to discipline children with behavior problems and teach them to be independent.

Conclusion. The proportion of behavior problems in children with epilepsy without neurologic deficit and intellectual disability, are not high. There are no risk factors for development of behavior problems. Family adaptation on managing children with epilepsy without behavior problems are better than family who have children with epilepsy and behavior problems."