Skripsi

Faktor Risiko Internal Terjadinya Epilepsi Resisten Obat Pada Pasien Epilepsi Anak Usia < 3 Tahun = Internal Risk Factors Associated with Drug-Resistant Epilepsy in Pediatric Patients Under Three Years of Age.

Latar Belakang Epilepsi resisten obat (ERO) adalah kegagalan remisi frekuensi dan durasi kejang setelah mengonsumsi dua atau lebih OAE secara teratur dan tepat. Antara 1 dari 3 orang yang mengidap epilepsi berkembang menjadi ERO dan sebanyak 35-65% anak dengan ERO berusia di bawah 3 tahun. Namun, data mengenai faktor risiko internal ERO pada anak yang berusia di bawah 3 tahun masih terbatas. Metode Penelitian ini merupakan studi observasional analitik dengan desain kasus kontrol yang bertujuan untuk meneliti hubungan faktor-faktor risiko internal ERO pada anak berusia di bawah 3 tahun dengan ERO. Data penelitian dianalisis secara univariat, bivariat, dan multivariat menggunakan program Statistical Package for the Social Sciences versi 26 (SPSS 26.0). Hasil Sebanyak 91 subjek populasi kasus dan 91 subjek populasi kontrol diikutsertakan dalam penelitian ini. Berdasarkan hasil analisis bivariat (p < 0.05) dan analisis multivariat (p < 0.25), mikrosefalus kongenital dan kelahiran prematur terbukti sebagai faktor risiko internal terjadinya ERO pada anak berusia di bawah 3 tahun. Kesimpulan Mikrosefalus kongenital dan kelahiran prematur secara independen terbukti meningkatkan risiko terjadinya ERO pada anak berusia di bawah 3 tahun, sedangkan riwayat infeksi TORCH selama kehamilan, riwayat preeklamsia, riwayat epilepsi dalam keluarga, berat badan lahir rendah, perdarahan intraventrikuler, dan hiperbilirubinemia tidak terbukti meningkatkan risiko terjadinya ERO pada anak berusia di bawah 3 tahun. Namun, riwayat eklamsia masih belum dapat dievaluasi.
Kata Kunci: epilepsi resisten obat, faktor risiko, mikrosefalus kongenital, kelahiran prematur


Introduction Drug resistant epilepsy (DRE) is defined as failure to achieve seizure remission despite regular use of two or more appropriate antiepileptic medications regularly. One out of three individuals diagnosed with epilepsy developed DRE, with 35%-65% of children diagnosed with DRE being under three years old. However, evidence regarding the internal risk factor contributing to DRE in children being under the age of three remains limited. Method This is a case control study design that aims to examine the association between internal risk factors of DRE in children under three years of age and the occurrence of DRE. The research data were analyzed univariately, bivariately, and multivariately using Statistical Package for the Social Sciences version 26 (SPSS 26.0). Results A total of 91 case subjects and 91 control subjects were included in this study. Based on the results of bivariate analysis (p < 0.05) and multivariate analysis (p < 0.25), congenital microcephaly and preterm birth were found to be internal risk factors for drug-resistant epilepsy (DRE) in children aged under three years old. Conclusion Congenital microcephaly and preterm birth have been shown to increase the risk of DRE in children younger than three years old. Whereas maternal history of TORCH during pregnancy, history of preeclampsia, family history of epilepsy, low birth weight, interventricular hemorrhage, and hyperbilirubinemia were not proven to increase the risk of DRE in children aged below three years old. However, history of eclampsia could not be evaluated.
Keywords: drug resistant epilepsy, risk factor, congenital microcephaly, and preterm birth