LAPORAN KASUS Kejang Demam Sederhana
April 24, 2019 | Author: evimeilisa | Category: N/A
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LAPORAN KASUS Kejang Demam Simpleks
Pembimbing: Dr. Lilis ,Sp.A
Oleh: Yossey Prai!i "#$%$&'$%()*
K+PAN-+RAAN KLNK S-AS+ P+DA-R RS PONDOK KOP /AKUL-AS K+DOK-+RAN DAN K+S+0A-AN UN1+RS-AS 2U0A22ADYA 2U0A 22ADYA0 0 AKARA KAR-A A #$%3
1
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KA-A P+N4AN-AR
Segala puji bagi Allah yang telah memberikan nikmat yang sangat luas kepada kita semua. Atas pertolongan dan kekuasaan-Nya yang begitu sempurna, penulis dapat menyelesaikan tugas kepaniteraan Ilmu Kesehatan Anak ini. Shalawat serta salam juga penulis haturkan ke junjungan besar Nabi Muhammad SA yang telah membawa umat manusi manusiaa dari dari !aman !aman "ahill "ahilliya iyah h menuju menuju !aman !aman yang penuh #ahaya #ahaya bagi bagi umat umat yang berta$wa kepada-Nya. %enulis menyadari ketidaksempurnaan tugas laporan kasus ini. &leh karena itu, penulis sangat mengharapkan saran, kritik, dan koreksi untuk perbaikan penyajian laporan kasus ini. Semoga karya ini dapat berman'aat bagi khalayak.
"akarta, No(ember )*1+
%enulis
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DA/-AR S
KAA %NA %N ANA/ NA/) ) 0AA/ 0A A/ ISI ISI2 2 I. 3A% 3A%&/AN &/AN KAS4 KAS4S S II. IN" IN"A4A A4AN N %4SAKA % 4SAKA12 12 ).1 Kejang 0emam.................................................................................................................. ).1.1 0e'inisi ).1.) Klasi'ikasi................................................................................................................. ).1.2. t tiol iolog ogii1+ ).1.+. aktor /isiko........................................................................................................... ).1.5. %at %ato'is o'isiol iologi ogi15 15 ).1.6. Man Mani'es i'estas tasii Klin Klinis is15 15 ).1.7. %emerik %emeriksaan saan %enun %enunjang jang18 18 ).1.9. 0iagnosa :anding.................................................................................................... ).1.8. Kom Komplik plikasi asi)1 )1 ).1.1* %enat %enatalaksan alaksanaan aan1 1 0AA/ 0A A/ %4S % 4SAKA AKA)+ )+
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LAPORAN KASUS S-A-US 5AN4SAL
I. I0NIAS Nama
; An. An. /.."
"enis Kelamin
; 3aki-laki
empat tanpa keluhan. %ersalinan dengan #ara S? ditolong ditolong dokter =karena ibu &s tidak kuat saat pembukaan ke +>. :ayi #ukup bulan, langsung menangis dan tidak terdapat #a#at bawaan dengan berat lahir 29**gr, panjang badan +9 #m.
Ri!aya -6mb6h Kembang •
2oorik 2oorik kasar: kasar: 4sia 4sia 2 bula bulan n meng mengang angkat kat kepala kepala,, usia usia 6 bula bulan n anak anak mula mulaii
merangkak dan duduk, usia 11 bulan anak sudah mulai berjalan. Saat ini anak •
sangat akti' bergerak. 2oorik hal6s ; 4sia 2 bulan sudah memegang gerin#ingan. Saat ini anak sudah
•
mampu menggenggam dengan kuat. 5i9ara ; 4sia 2 bulan mulai mengo#eh. Saat ini anak sudah dapat mengu#apkan )-2
•
kata seperti mama, papa, mamam, kakak, nenek,susu>. Anak mulai mengenal wajah orangtuanya dan tersenyum usia 2 bulan. Saat Sosial ; Anak ini anak akti' bermain dengan teman sebaya dan orang di rumah.
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ASI diberikan dari &S lahir hingga usia 2 bulan, dikarena ASI sedikit, dan usia 2 bulan B 6 bulan di tambah susu 'ormula 5-6 botol ke#il 5* ml per hari. 4sia 6 bulan keatas anak mendapat makanan tambahan berupa 1 mangkuk ke#il bubur beras merah ) C sehari ditambahn susu 'ormula )-2 botol per hari. Saat ini, anak diberi makan 1 porsi berisi 1 #entong nasi yang dilemberikin dengan lauk 1 telur goreng atau 1 lengkap
4sia * bln dengan skar + mm ) bln< + bln< 6 bln * bln< ) bln< + bln< 6 bln * bln< 1bln< 6bln 8 bln
Anamnesis Sisem:
SS %
;Saat ke k ejang ka k aki da d an ta t angan ka k aku ke k emudian kl k lojotan ya y ang berlangsung selama 5 menit kemudian berhenti sendiri. Setelah kejang, os sadar dan menangis
Mata
; mata merah =->, mata berair =E>, nyeri pada mata =->
D
; gangguan pendengaran =->, riwayat keluar #airan dari telinga =->
Kardio dio(askular
; be berdebar bar-deba ebar ==->
/espirasi
; batuk =->, pilek =->.
as astroi troint ntes esttinal nal
; gang ganggu guan an :A: :A: di disang sangka kall
4rogenital
; anggaun :AK disangkal
ndokrin
; pe pembesaran ke kelenjar di di le leher ==->, ke kelainan ge genital di disangkal
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Kesan Um6m ; nampak sakit sedang
-an8a ial
1. Suhu
; 29 * ? =aksila>
). Nadi
; 9) kali, :rud!inki I =->, :rud!inki II =->, Kernig
E E Sign =->,
3asegue sign =-> Genitalia
; 3aki-laki, 3aki-laki, kelainan genital =->
IJ. %M/IKSAAN %N4N"AN; anggal anggal *6 no(ember )*1+ Pemeriksaan
0asil
Sa6an
Normal
Demaglobin 3eukosit Dematokrit rombosit %emeriksaan :aso'il osino'il Neutro'il 3ymposite Mono#yte
1*.6 7. * 3 2) )6+ Dasil *.2 3 * .2 6).7 )).* D 1 +.7
mg yang disebabkan oleh proses ekstrakranium. Anak yang pernah mengalami kejang tanpa demam, kemudian kejang demam kembali tidak termasuk kejang demam.
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2. :erula :erulang ng lebih lebih dari dari 1 kali kali dalam dalam wakt waktu u )+ jam
nsi8en
Kejang demam terjadi pada anak berusia 6 bulan sampai 5 tahun. 4sia pun#ak terjadinya terjadinya kejang demam demam adalah antara 1+ sampai 19 bulan. bulan. 0apat terjadi terjadi pada semua ras, anak laki B laki insiden terjadinya kejang demam lebih tinggi dari anak perempuan. 0an insiden terjadinya kejang demam adalah ) H. =)> tiolo tiologi gi dan pathoge pathogenes nesis is tidak tidak diketah diketahui ui dengan dengan pasti pasti tetapi tetapi 'aktor 'aktor genetik genetik berpengaruh dalam meningkatkan terjadinya kejang demam. Insiden terjadinya kejang demam pada anak yang orang tuanya tuanya pernah mengalami kejang demam adalah 9 B )) H dan jika saudaranya mengalami kejang demam insidennya adalah 8 B 17 H.
=)>
:erdasarkan penelitian yang telah dilakukan, kromosom 18p dan 9$12 B )1 telah dipetakan sebagai kromosom yang berhubungan dengan terjadinya kejang demam. 0i negara Amerika, antara ) H - 5 H anak B anak menderita kejang demam pada usia 5 tahun. Satu pertiga dari pasien ini akan mengalami rekurensi. 0i ropa barat diperoleh data statistik yang serupa dengan di Amerika, sedangkan insiden di negara lain #ukup
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5. 0engan 0engan adanya adanya minima minimall ) 'aktor 'aktor resiko resiko diatas diatas dapat dapat meningkat meningkatkan kan probabil probabilita itass terjadinya terjadinya kejang demam. %robabilitas %robabilitas kejang demam yang akan terjadi terjadi pertama pertama kali adalah 2* H 6. Ibu Ibu yang yang mengk engkon onsu sums msii alko alkoho holl dan dan mero meroko kok k saat saat masa masa keha kehami mila lan n akan akan memiliki resiko ) kali lebih tinggi dari yang tidak Satu pertiga dari jumlah anak B anak yang pernah memiilki riwayat kejang demam akan dapat menderita kejang demam berulang. Pang masih menjadi dilema adalah karena tidak tidak ada data data yang yang menduku mendukung ng teori teori bahwa bahwa peningk peningkata atan n suhu suhu dapat dapat menyebab menyebabkan kan kejang demam. =2> Kejang Kejang demam demam akan akan terjad terjadii kembal kembalii pada sebagi sebagian an kasus. kasus. aktor aktor resiko resiko yang yang dapat menyebabkan kejang demam berulang adalah =1> 1. /iwaya /iwayatt kejang kejang demam demam dalam dalam keluar keluarga ga ). 4sia 4sia kura kurang ng dari dari 15 15 bula bulan n 2. empe emperat ratur ur yang yang renda rendah h saat saat kejang kejang +. ?epat ?epatny nyaa kejan kejang g setel setelah ah demam demam :ila seluruh 'aktor di atas ada, kemungkinan berulang 9*H, sedangkan bila tidak
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menjaga keseimbangan potensial membran ini diperlukan energi dan bantuan en!im NaK-A%ase K-A%ase yang terdapat pada permukaan sel.
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=5>. Setelah itu terjadilah hiperpolarisasi, dimana Ion KE ikut keluar ke ekstra sel, setelah itu kemnbali ke posisi istirahat. Melalui gambar 1, dapat dijelaskan bahwa kejang dapat terjadi jika pompa Ion Natrium B Kalium terus terjadi dan melampaui a mbang batas atas potensial aksi.
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Neurotransmitter dalam jumlah besar
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Anak Anak yang ang
mend mender erit itaa keja kejang ng dema demam m seba sebaik ikny nyaa dila dilaku kuka kan n pem pemerik eriksa saan an
penunjang. %emeriksaan rutin berupa elektrolit serum, glu#osa darah, #alsium, 'oto rRetgen tulang, dan pen#itraan otak dapat membantu menegakkan diagnosis. %eningkatan leukosit leukosit sampai diatas )*.***
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