To Mba Siska ...

Ini ada artikel ttg kejang Demam ... Aku dapet dari milis Sehat ... Moga 
bermanfaat ya ...


salam,
Lia/K's mom

*ygpernahngalaminwaktuanakkejang*

http://www.idai.or.id/web/topik/detil.asp?IDTopics=62
Kejang Demam pada Anak
dr. Hardiono Pusponegoro


KEJANG demam adalah penyakit  pada anak yang disebabkan oleh demam. Umumnya, 
sekitar 2% sampai 5% anak berumur antara enam bulan sampai lima tahun mengalami 
demam ini. Namun tidak sampai menginfeksi otak anak.

Apa yang harus dilakukan bila anak mengalami kejang demam? Walaupun kejang 
demam terlihat sangat menakutkan, sebenarnya jarang sekali terjadi komplikasi 
berat. Yang paling penting (dan paling sulit) adalah untuk tetap tenang.

Lihat jam untuk menentukan berapa lama kejang berlangsung. Jangan memasukkan 
sendok atau jari ke dalam mulut anak untuk mencegah
lidahnya tergigit. Hal ini tidak ada gunanya, justru berbahaya karena gigi 
dapat patah atau jari luka. Miringkan posisi anak sehingga ia tidak tersedak 
air liurnya. Jangan mencoba menahan gerakan anak. Turunkan demam dengan membuka 
baju dan menyeka anak dengan air sedikit
hangat. Setelah air menguap, demam akan turun. Jangan memberi kompres dengan es 
atau alkohol karena anak akan menggigil dan suhu di dalam tubuh justru 
meningkat, walaupun kulitnya terasa dingin. Bila ada, Anda dapat memberikan 
diazepam melalui anus. Untuk anak dengan berat badan kurang dari 10 kg dapat 
diberikan obat, sebagian besar kejang demam akan berhenti sendiri sebelum lima 
menit.

Apakah anak perlu masuk rumah sakit?
Bila kejang berlangsung kurang dari lima menit, kemudian anak sadar dan 
menangis, biasanya tidak perlu dirawat. Bila demam tinggi, kejang
berlangsung lebih dari 10-15 menit, kejang berulang atau anak tidak sadar 
setelah kejang berhenti. Anda harus membawanya ke Dokter atau Rumah Sakit.

Untuk membantu menentukan apa yang akan terjadi pada anak dikemudian hari, 
kejang demam dibagi dalam kejang demam sederhana dan kejang kompleks.

Kejang demam sederhana adalah bila kejang berlangsung kurang dari 15 menit dan 
tidak berulang pada hari yang sama, sedangkan kejang kompleks adalah bila 
kejang hanya terjadi pada datu sisi tubuh, berlangsung lama lebih dari 15 menit 
atau berulang dua kali atau lebih dalam satu hari.

Kejang demam sederhana tidak menyebabkan kelumpuhan, meninggal atau mengganggu 
kepandaian. Risiko untuk menjadi epilepsi di kemudian hari juga sangat kecil, 
sekitar 2% hingga 3%. Risiko terbanyak adalah berulang kejang demam, yang dapat 
terjadi pada 30 sampai 50% anak. Risiko-risiko tersebut lebih besar pada kejang 
yang kompleks.

Rekaman otak atau electroencephaiografi (EEG) biasanya tidak dilakukan secara 
rutin, karena tidak berguna untuk memperkirakan apakah kejang akan berulang 
kembali, juga tidak dapat memperkirakan apakah akan terjadi epilepsi di 
kemudian hari. Pemeriksaan CT scan atau MRI juga tidak perlu dilakukan.

Untuk anak dengan kejang kompleks atau anak mengalami kelainan saraf yang 
nyata, dokter akan mempertimbangkan untuk memberikan pengobatan dengan anti 
kejang jangka panjang selama 1-3 tahun. Obat yang digunakan misalnya 
phenobarbital yang sangat efektif untuk mencegah berulangnya kejang, namun di 
sisi lain memiliki efek samping menyebabkan anak menjadi hiperaktif.

Obat lain misalnya asam valproat, sama efektifnya untuk mencegah berulangnya 
kejang namun mepunyai efek samping mengganggu fungsi hati, terutama pada anak 
berumur kurang dari 2 tahun. Dokter akan memberi anda pilihan yang terbaik. 

------------------------------- 

Original Article:
http://www.mayoclinic.com/invoke.cfm?id=DS00346 
Febrile seizure

Overview 

A febrile seizure is a convulsion that occurs in young children, triggered by a 
high fever. Febrile means pertaining to or characterized by a fever. A febrile 
seizure typically lasts 5 minutes or less, though some may last longer. Most 
children who experience a febrile seizure are between the ages of 6 months and 
5 years. 

Although a febrile seizure may be very alarming to you, it usually is harmless 
to your child and usually doesn't indicate a long-term or ongoing problem. 
Still, a febrile seizure is always a reason to seek medical attention, 
especially to determine the cause of the fever. 

Febrile seizures are the most common type of seizure during childhood. They 
occur in about 4 percent of children before the age of 4 years. Many children 
never have another febrile seizure. Some children inherit a tendency to have 
seizures along with a fever. Febrile seizures usually stop by the time a child 
is 5 or 6 years old. 

Signs and Symptoms 

Signs of a febrile seizure include: 

  a.. Repeated rhythmic jerking or stiffening of your child's arms and legs 
  b.. Eyes rolled back in your child's head 
  c.. Lack of consciousness
A febrile seizure usually is due to a rapid rise in your child's temperature, 
but the above signs don't necessarily reflect the height of the fever. Most 
febrile seizures are short, with the signs usually lasting 5 minutes or less. 
After the seizure, your child may cry or be quite sleepy. 
Causes 

A febrile seizure may be triggered by a rapidly developing fever, which could 
be caused by an infection in any part of your child's body. The fever is 
usually from a typical childhood illness, such as a middle ear infection. A 
less common but very serious cause of a seizure is an infection of a child's 
central nervous system (brain and spinal cord). One such infection is 
meningitis, a condition in which membranes surrounding the brain become 
infected. Another is encephalitis, an inflammation in the brain itself. 

Risk Factors 

Young age is the strongest risk factor. Most febrile seizures occur between the 
ages of 6 months and 5 years, and the highest likelihood of febrile seizures is 
in children between the ages of 12 months and 18 months. Some children inherit 
a family's tendency to have seizures with a fever. 

When to Seek Medical Advice 

Seek medical attention immediately if your child has a seizure, develops a 
stiff neck, becomes confused or delirious, is difficult to wake up or acts very 
sick. First-time febrile seizures should be evaluated by your doctor as soon as 
possible. 

Screening and Diagnosis 

Your doctor will need to examine your child to determine the possible causes of 
the fever and seizure. Your doctor may order blood and urine tests to detect an 
infection. 

If your doctor suspects a central nervous system infection, a spinal tap 
(lumbar puncture) may be necessary. In this procedure, approximately one-half 
teaspoon of spinal fluid is removed with a needle appropriately placed into the 
child's lower back. This test can reveal evidence of infection in the fluid 
that surrounds the brain and spinal cord. 

Complications 

Although they may greatly concern you as a parent, the vast majority of febrile 
seizures produce no lasting effects. 

Febrile seizures are classified as simple or complex. Researchers currently 
believe that simple febrile seizures cause no higher incidence of subsequent 
epilepsy, cerebral palsy or mental retardation. A complex febrile seizure lasts 
longer than 15 minutes, occurs more than once within 24 hours or is confined to 
one side of the body. Complex febrile seizures may carry a somewhat higher risk 
of subsequent seizures. 

If your child experiences a febrile seizure, you might wonder whether he or she 
has a more serious underlying disorder, such as epilepsy. However, epilepsy in 
children is defined as recurring seizures in the absence of fever. The odds 
that your child will develop epilepsy after a febrile seizure are small. 
Between 95 percent and 98 percent of children who have a simple febrile seizure 
will never develop epilepsy. However, children with epilepsy are more likely to 
have seizures when they have a fever, because fever lowers the seizure 
threshold. 

Treatment 

The vast majority of febrile seizures stop on their own within 5 minutes. 
However, if the seizure lasts for more than 5 minutes — or if your child has 
two or more seizures — call for emergency medical attention. 

If the seizure is still occurring when your child arrives at the emergency 
room, a doctor may order medication administered either through your child's 
rectum or intravenously to stop the seizure. 

It's possible that the doctor will want your child to stay in the hospital 
briefly for further observation. But a hospital stay isn't always necessary. 

Prevention 

If your child is susceptible to febrile seizures, it may be possible to prevent 
these seizures by taking quick action to control fever when your child has an 
illness. 

Most of the time, a febrile seizure occurs during the first day of an illness. 
By giving your child acetaminophen (Tylenol, others) or ibuprofen (Advil, 
Motrin, others) at the first indication of fever, you may reduce the chance of 
a febrile seizure. But don't give aspirin to children. Aspirin may trigger a 
rare but potentially fatal disorder known as Reye's syndrome. Also, don't 
bundle up your child too much at night, and make sure your child drinks plenty 
of fluids. 

It also is possible to prevent febrile seizures by having your child take a 
prescription anticonvulsant medication until age 3 or 4. However, doctors 
rarely prescribe these medications because most febrile seizures are harmless 
and most children outgrow them without any problems. 

Medications that prevent seizures have drawbacks. Anticonvulsant medications 
such as valproic acid (Depakene) and divalproex (Depakote) are effective in 
preventing febrile seizures, but they carry a significant risk of serious side 
effects in young children. Children who have frequent or prolonged febrile 
seizures might benefit from preventive treatment with oral or rectal diazepam 
(Valium, Diastat). 

Self-Care 

Although febrile seizures are usually harmless, these steps can help your child 
avoid injury during the seizure: 

  a.. Place your child on his or her side, somewhere where they won't fall. 
  b.. Stay close beside to watch and comfort your child. 
  c.. Remove any hard or sharp objects near your child. 
  d.. Loosen tight or restrictive clothing. 
  e.. Don't restrain your child or interfere with your child's movements. 
  f.. Don't attempt to put anything in your child's mouth.
Within 1 to 2 hours of a febrile seizure, many children are back on their feet, 
running around the doctor's office or playing safely at home. By staying calm, 
observing your child and knowing when to call the doctor, you're doing 
everything that's needed to take care of your child. 
By Mayo Clinic staff 

DS00346 

April 15, 2002 

© 1998-2004 Mayo Foundation for Medical Education and Research (MFMER). All 
rights reserved.  A single copy of these materials may be reprinted for 
noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "Mayo 
Clinic Health Information," "Reliable information for a healthier life" and the 
triple-shield Mayo logo are trademarks of Mayo Foundation for Medical Education 
and Research.  
-------------------------------------------------------------------- 
This message contains confidential information and is intended only for the 
addressee named. If you are not the named addressee (or authorised to receive 
for the addressee), you must not disseminate, distribute or copy this 
email.Please notify the sender immediately by e-mail if you have received this 
e-mail by mistake and delete this e-mail from your system 

Kirim email ke