Epilepsy Papers

CHAPTER I
INTRODUCTION

 A. Background

Epilepsy is defined as a syndrome characterized by impaired brain function are temporary and paroxysmal, which gives the manifestation of disorder, or loss of consciousness, impaired motor, sensory, psychological, and autonomous systems, and is episodic. Cognitive memory deficits are a problem most often occurs in pederita epilepsy.


Every person has a risk of one in 50 to get epilepsy. Drug users and alcohol drinkers had a higher risk. Narcotic users may get a first seizure due to use of narcotics, but then may continue to have seizures despite being separated from narkotik.Di UK, one person among the 131 people suffering from epilepsy.

Epilepsy can affect children, adults, parents and even newborn babies. The incidence of epilepsy is higher in men than in women, ie 1-3% of the population will suffer from epilepsy for life. In the United States, one in 100 population (1%) population susceptible to epileptic seizures, and approximately 2.5 million of whom have undergone treatment in the last five years. According to the World Health Organization (WHO), approximately 50 million people worldwide suffer from epilepsy (2004 Epilepsy.com.)

CHAPTER II
Reader Reviews

A. Definition
Epilepsy that is difficult to control medically or pharmacoresistant, because the majority of patients with epilepsy is resistant, most often attacked in advance of the head. Drugs that can soothe antiepileptik the standard. Related to biomolekular base complex. Headache attack is very difficult to be treated by pharmacological, although already in an optimal antiepileptic drug is given, about 30-40% of epilepsy patients are infected, patients usually perform surgery to relieve pain temporarily. But the symptoms of epilepsy will occur occasionally, because epilepsy is difficult to remove the head pain that attack.

B. Risk Factors
Epilepsy can affect children, adults, parents and even newborn babies. The incidence of epilepsy is higher in men than in women, ie 1-3% of the population will suffer from epilepsy for life. In the United States, one in 100 population (1%) population susceptible to epileptic seizures, and approximately 2.5 million of whom have undergone treatment in the last five years. According to the World Health Organization (WHO), approximately 50 million people worldwide suffer from epilepsy (2004 Epilepsy.com.)

C. Epidemiology
Basically everyone can have epilepsy. Every person has a brain with each generation threshold is more resistant or less resistant to the emergence of resurrection. In addition, the cause of epilepsy is quite diverse: brain injury, poisoning, stroke, infection, parasitic infestation, a brain tumor. Epilepsy can occur in males and females, any age, and race whatever. The number of people with epilepsy include 1-2% of the population. In general, shows the incidence of epilepsy showed bimodal pattern: the peak incidence in the group there are children and elderly.

D. Etiology
Etiologic factors affect the determination of prognosis. The main cause, is idopatik epilepsy, remote symptomatic epilepsy (RSE), acute symptomatic epilepsy, and epilepsy in children based on brain damage at the time of peri-or antenatal. Within these classifications there are two prominent types of epilepsy, epilepsy is idiopathic and RSE. From these two there are many different etiologies and syndromes, each with a good prognosis and bad.

Symptomatic epilepsy based on brain tissue damage was evident on CT scan or magnetic resonance imaging (MRI) and no apparent brain damage but against a background of antenatal or perinatal problems with obvious neurologic deficit. Meanwhile, the view of the possibility of re-generation of post-awitan.

The definition of neurologic in relation to the age when awitan have predictive value as follows:
• If at the time of birth, the neurologic deficit has occurred within the first 12 months the whole case will have re-generation,
• If the neurologic deficit occurs when the risk of postpartum re-generation is 75% in the first 12 months and 85% in the first 36 months. In addition, the first generation that occurs during acute brain disorder will have a risk of 40% in the first 12 months and 36 months for the occurrence of re-awakening. Overall the risk for re-generation is not constant. Most cases showed re-generation within the first 6 months.

E. Pathogenesis
The nervous system is a communication network (communication network). The brain communicates with the organs of the body through nerve cells (neurons). In normal conditions, nerve impulses from the brain electrically will be brought neurotransmitters such as GABA (gamma-aminobutiric acid) and glutamate by nerve cells (neurons) to the organs of the body. Causative factors of epilepsy in this system interfere, causing power imbalance in nerve cells and cause seizures that are characteristic of epilepsy.

Factors trigger epilepsy:
• Pressure,
• Lack of sleep or breaks,
• Sensitive to bright light (photo sensitive), and
• Drinking alcohol.

F. Diagnosis
Evaluation of patients with paroxysmal nature of symptoms, especially with an unknown factor, requires specialized knowledge and skills to explore and discover relevant data. The diagnosis of epilepsy was based on anamnesis and clinical examination combined with the results of EEG and radiologis.penderita or their parents need to be asked to testimony about the history of epilepsy the family. Then proceed with multiple checks, among others:

• Physical Examination
This examination is sifting the causes of generation by using the age and history of the disease as a handle. On auscultation elderly neck region is important to detect vascular disease. In children, judging by the slow growth, sebaceous adenoma (tuberous sclerosis), and organomegali (srorage disease).

• Electro-ensefalograf
EEG patterns in epilepsy may help to determine the type and location of generation. Epileptiform wave comes from the spark paroxysmal sourced on a group of neurons that have a synchronous depolarization. Overview of the recorded EEG epileptiform anatarcetusan appeared and stopped abruptly, often with a distinctive morphology.

• Examination of the brain imaging
MRI aims to look at brain structure and complete EEG data. Useful to compare the right and left hippocampus. One also can identify abnormalities of brain growth, the tumors are small, certain vascular malformations, and diseases of demyelination.
Differential Diagnosis

• Genesis paroxysmal
Differential diagnosis for paroxysmal events that are included sinkrop, migraine, TIA (TransientIschaemic Attack), periodic paralysis, gastrointestinal disorders, disorders of movement and breath holding spells. This diagnosis is fundamental.

• simple partial epilepsy
Diagnosis includes TIA, migraine, hyperventilation, tics, mioklonus, and spasmus hemifasialis. TIAs can occur with sensory symptoms are distinguished from simple partial epilepsy. Both paroksimal, generation may be losing sight for a moment, and experience of elderly patients.

• complex partial epilepsy
Differential diagnosis is related to the level of loss of consciousness, ranging from drop attacks through behavior patterns that rumit.secara common diagnoses include sinkrop, migraine, sleep disorders, non-epileptic attack, narcolepsy, metabolic disorders and transient global amnesia.

G. Management
Once the diagnosis is established, the therapeutic actions are maintained. All people who suffer from epilepsy, both idiopathic and non-idiopathic, but the underlying pathological process is progressive not active as cerebral tumor, should receive medicinal therapy. Drug choice for eradication of epileptic attacks of any kind, other than petit mal, is luminal or phenytoin. To determine the dose must be known luminal patients' age, type epilepsinya, frequency of attacks and when the doctors treated another. Doses of drugs being used. For children luminal dose is 3-5 mg / kg / BW / day, while adults do not need a dose of it. Adults need 60 to 120 mg / day. Dose of phenytoin (Dilatin, Parke Davis) for children is 5 mg / kg / BW / day for adults and 5-15 mg / kg / BW / day. Effects phenytoin 5 mg / kg / BW / day (approximately 300 mg daily) had seen in five days. So if the direct effect to be achieved at doses of 15 mg / kg / BW / day (approximately 800 mg / day) should be used.

Anticonvulsant effect can be assessed on the 'follow up'. Patients with common assault frequency of 3 times a week is much easier to treat compared with patients who have a frequency of 3 times a year. On the visit of 'follow up' to be reported good results, bad or that can not be judged good or bad because of the frequency of attacks before and during the new therapy is still about the same. When the frequency is reduced by appeal, the doses being used needs to be increased slightly. When frekuensinay fixed, but the attack epileptic patients assessed by their parents or people with epileptic Jackson motor / sensory / 'march' as 'light' or 'much lighter', then the doses used may be continued or increased slightly. If the result is bad, the dose should be increased or added to other anticonvulsants.
Therapy Treatment of Epilepsy:

The first drug most commonly used:
(Such as: sodium valporat, phenobarbital and phenytoin)
• It is recommended for people with epilepsy new
• These medications will give side effects such as gum swelling, dizziness, acne and body fur (Hirsutisma), swollen seed kelenjardan osteomalakia.

The second drug commonly used: (such as lamotrigine, tiagabin, and gabapetin)
• If there is no change in the patient's head after the first drug use, the drug will be added with the second drug.
• Lamotrigine has been released as the first drug in Malaysia.
• New drugs are introduced do not have side effects, especially in terms of disability during birth.

CHAPTER III
CLOSING

A. Conclusion

Epilepsy is a disorder of the central nervous system (CNS) characterized by the occurrence of resurrection (seizure, fit, attact, spell) a spontaneous (unprovoked) and periodic. Generation can be interpreted as a modification of brain function that are sudden and quick, which is derived from a large group of brain cells, is singkron and rhythmic. The rise of epilepsy occurs when the excitation processes in the brain is more dominant than the inhibition process.

Every person has a risk of one in 50 to get epilepsy. Drug users and alcohol drinkers had a higher risk. Narcotic users may get a first seizure due to use of narcotics, but then may continue to have seizures despite being separated from the narcotic. Generally epilepsy may be caused by brain damage in the process of birth, head injury, stroke, brain tumors, alcohol. Sometimes epilepsy may also be due to genetic, hereditary disease but not epilepsy. But the exact cause remains unknown.

References

- Harsono.2007.Epilepsi, Gadjah Mada University Press, Yogyakarta
- Sidhartha, Priguna M.D., Ph. D.1999. Clinical Neurology in general practice, Dian Rakyat, Jakarta.
- Http / / epilepsi.web. / / Www.google.co.id//2009