Perbedaan Efek Fenitoin dan Valproat dalam Menimbulkan Gangguan Kognitif Epilepsi Anak Bangkitan Umum Tonik Klonik  

Oleh:

Tan, Surya ; Sudarmadji, Sri Sutarni ; Dahlan, Pernodjo

Jenis: Article from Journal - ilmiah nasional
Dalam koleksi: Berkala Kesehatan Klinik vol. 14 no. 02 (Dec. 2008), page 88-97 .
Topik: phenytoin -valproat- cognitive impairment -child epilepsy- general tonic clonic

Ketersediaan

Perpustakaan FK Nomor Panggil: B25.K.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Background: Epilepsy represents one of neurological disorder which is frequently happened. Prevalence Epilepsy in developed countries ranges from 5-7 per 1000 population, by incidence range from 30-60 per 100.000 populations. Management of Epilepsy is based on Medicine Anti Epilepsy Drug (AED) and about 60%-70% manageable patient of seizure. The use AED is often attributed by side effects of idiosincration, cognitive impairment and other complication effect of long-range use, so that require to consider the benefit of medicine and side effects which can be happened. The potential child experience of the heavier cognitive impairment compared adult. Between existing OAE, phenytoin and valproat represent the drug most is often used to control the attack epilepsy of general tonic clonic. Objective: This research aim to know how big risk phenytoin in cognitive impairment of child epilepsy with the general tonic clonic compared with valproat. Methods: This is a case control study where subject of study is child suffer from epilepsy with the controlled general tonic clonic, old age 6-18 year which are treated with phenytoin or valproat during over or equal 6 month and ready to participate in this research. Diagnosis of cognitive impairment is based on score 3 of MSEC (Modified of Mini Mental examination Child) below value of cut of point from each age group. Data analysis is done by univariate (chi¬square) and multivariate. Result and Conclusion: Study includes 90 patient of child epilepsy which consists of the men and woman with average age is 11.4 year old. Forty five of them (50%) are experiencing of cognitive impairment and 45(50%) are experiencing cognitive without a hitch. Monotherapyof phenytoin and valproat can result the cognitive impairment but the difference of both is minimal and statistically does not significant (p>0.05). Duration of treatment more than 1 year have a significant effect in causing cognitive impairment (OR = 2.60; 95%CI=1.01-6.68; p=0.05). The use of monotherapy phenytoin more than 1 year shows bigger risk of cognitive impairment as compared with valproat.

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