SPASTIC FEVER
CONGENIALITY
Spastic Fever or of febrile convulsion is awakening spastic that happened at increase of body temperature (temperature of rectal above 380c) which because of process of ekstrakranium.
Fever spastic represent disparity of most neurologis is often met by at child, especially at child faction old age 6 months - 4 year (Milichap, 1968)
CAUSE
The happening of spastic at child and baby most at the same time with increase of high temperature and quickly because infection outside SSP like tonsillitis, GRANDMOTHER, furunkolosis
PATOFISIOLOGI
Glucose represent the source of all important energi to brain which passing oxidation process broken to become CO2 and water.
Under normal circumstances, cell membrane of neuron very is easy passed by potassium ion, difficult passed by by ion of natrium other electrolyte and, except chloride ion so that happened potential difference [of] membrane of cell of neuron, where in high potassium rate cell and low natrium.
Energi needed to to balance potentially of membrane and assisted by enzyme of Na-K-Atpase which there are on the surface of cell. This balance earn annoyed by existence of 1. Change of room ion concentration of ekstraseluler 2. Incoming excitement of sudden him ( mechanical, kimiawi, electric current 3. Change of cell membrane patofisiologi (disease, herediter)
At increase of temperature 10c resulting increase of dropsy metabolism 10 - 15 % and requirement of o2 mount 20 %. At child of sirkulasi tired brain 65 % from entire/all body while at adult only 15 %. Becoming at increase of certain temperature earn happened change of balance of cell membrane of neuron and in a short time happened diffusion of ion of natrium potassium and which cause to release very big electricity him and can extend cell keseluruh and also its neighbour cell membrane constructively neurotransmitter so that terjadilahkejang.
Every child have different spastic sill from lowering that is 380c until high sill that is 400c / happened newer of spastic. Fever spastic that goes on shorten is not dangerous and do not generate symptom of is rest of. Spastic old ones (> 15 minutes) dangerous will generate symptom of is rest of.
SYMPTOM of KLINIS
Spastic happened first within 24 hours fever time " Nature of awakening tonik, klonik, tonik-klonik, fokal / akinetik " Spastic can desist by xself and child do not give any reaction to a moment after some second / minute will be woke up and regain consciousness
CRITERION SPASTIC FEVER and of PENDIAGNOSAAN SPASTIC FEVER
Livingston ( 1954, 1963) making criteria and divide fever spastic become 1. simple Fever spastic (convulsion febrile simple " [common/ public] Spastic " Its time shorten " first Attack age less than 6 year " Attack Fruekensi 1 - 4 times pertahun " Normal EEG 2. Epilepsi which [is] provocation by fever ( Triggered fever by of Epilepsy " Old spastic / fokal " Age more than 6 year " Attack Fruekensi more than 4 times pertahun " EEG after fever is not abnormal.
Spastic fever diagnosis simply 1. Old age child when spastic [among/between] 6 months - 4 year 2. Spastic take place only a moment at the most 15 minute 3. Spastic have the character of public 4. Spastic arise in 16 first [hour/clock] after incidence of fever 5. Inspection of nerve before and after normal spastic 6. Fruekensi awaken spastic in 1 year at the most 4 times 7. EEG after at least 1 week after normal temperature do not show disparity.
If/When fever spastic [do] not fulfill one of the or seventh more than the criteria classified by at epilepsy which is provocation by fever.
MEDICATION
1. Overcoming spastic as soon as possible. Diazepam IV / perrektal
2. Medication of supporter " Clothes alleviated " Head position better heel to prevent stomach aspiration " Labouring free to breath road;street to guarantee requirement of oxygen, when needed [do/conduct] intubasi / tracheostomi " Suction of mucus regularly and give oxygen " Intravenous dilution with electrolyte monitoring and of metabolic " Compress if/when hiperpireksia " Kortikosteroid to prevent brain fever
3. Giving economical medication
Antiepileptik : fenobarbital, fenilhidaatoin. This medication is divided to become 2 shares a. Medication of intermitten profilaksis To prevent recurred of spastic return, patient which suffering given by simple fever spastic of mixture drug of antikonvulsan and of antipiretika which must be passed to child if suffering fever again b. Long-Range Profilaksis Utilize him to guarantee there are dose him of terapeutik stable and enough in patient blood to prevent recurred of spastic later on day. Drug weared by is " Fenobarbital 4 - 5 mg / singk of BB / hr " sodium of Valproat / sour of valproat ( epilin, depakene) dose 20 - 3 0 mg/kgBW/day divided by 3 dose " Fenitoin ( dilantin). Medication of antikonvulsi at this long-range profilaksis continued at least 3 year like medication of epilepsy. Discontinuing medication of antikonvulsi later slow have to by way of lessening dose during 3 months or 6 months.
4. Searching and ask apology cause
Cause of good fever spastic of simple fever spastic and also epilepsy which is diprovikasi by fever usually Acute Infection Channel Exhalationand GRANDMOTHER.
Spastic Fever or of febrile convulsion is awakening spastic that happened at increase of body temperature (temperature of rectal above 380c) which because of process of ekstrakranium.
Fever spastic represent disparity of most neurologis is often met by at child, especially at child faction old age 6 months - 4 year (Milichap, 1968)
CAUSE
The happening of spastic at child and baby most at the same time with increase of high temperature and quickly because infection outside SSP like tonsillitis, GRANDMOTHER, furunkolosis
PATOFISIOLOGI
Glucose represent the source of all important energi to brain which passing oxidation process broken to become CO2 and water.
Under normal circumstances, cell membrane of neuron very is easy passed by potassium ion, difficult passed by by ion of natrium other electrolyte and, except chloride ion so that happened potential difference [of] membrane of cell of neuron, where in high potassium rate cell and low natrium.
Energi needed to to balance potentially of membrane and assisted by enzyme of Na-K-Atpase which there are on the surface of cell. This balance earn annoyed by existence of 1. Change of room ion concentration of ekstraseluler 2. Incoming excitement of sudden him ( mechanical, kimiawi, electric current 3. Change of cell membrane patofisiologi (disease, herediter)
At increase of temperature 10c resulting increase of dropsy metabolism 10 - 15 % and requirement of o2 mount 20 %. At child of sirkulasi tired brain 65 % from entire/all body while at adult only 15 %. Becoming at increase of certain temperature earn happened change of balance of cell membrane of neuron and in a short time happened diffusion of ion of natrium potassium and which cause to release very big electricity him and can extend cell keseluruh and also its neighbour cell membrane constructively neurotransmitter so that terjadilahkejang.
Every child have different spastic sill from lowering that is 380c until high sill that is 400c / happened newer of spastic. Fever spastic that goes on shorten is not dangerous and do not generate symptom of is rest of. Spastic old ones (> 15 minutes) dangerous will generate symptom of is rest of.
SYMPTOM of KLINIS
Spastic happened first within 24 hours fever time " Nature of awakening tonik, klonik, tonik-klonik, fokal / akinetik " Spastic can desist by xself and child do not give any reaction to a moment after some second / minute will be woke up and regain consciousness
CRITERION SPASTIC FEVER and of PENDIAGNOSAAN SPASTIC FEVER
Livingston ( 1954, 1963) making criteria and divide fever spastic become 1. simple Fever spastic (convulsion febrile simple " [common/ public] Spastic " Its time shorten " first Attack age less than 6 year " Attack Fruekensi 1 - 4 times pertahun " Normal EEG 2. Epilepsi which [is] provocation by fever ( Triggered fever by of Epilepsy " Old spastic / fokal " Age more than 6 year " Attack Fruekensi more than 4 times pertahun " EEG after fever is not abnormal.
Spastic fever diagnosis simply 1. Old age child when spastic [among/between] 6 months - 4 year 2. Spastic take place only a moment at the most 15 minute 3. Spastic have the character of public 4. Spastic arise in 16 first [hour/clock] after incidence of fever 5. Inspection of nerve before and after normal spastic 6. Fruekensi awaken spastic in 1 year at the most 4 times 7. EEG after at least 1 week after normal temperature do not show disparity.
If/When fever spastic [do] not fulfill one of the or seventh more than the criteria classified by at epilepsy which is provocation by fever.
MEDICATION
1. Overcoming spastic as soon as possible. Diazepam IV / perrektal
2. Medication of supporter " Clothes alleviated " Head position better heel to prevent stomach aspiration " Labouring free to breath road;street to guarantee requirement of oxygen, when needed [do/conduct] intubasi / tracheostomi " Suction of mucus regularly and give oxygen " Intravenous dilution with electrolyte monitoring and of metabolic " Compress if/when hiperpireksia " Kortikosteroid to prevent brain fever
3. Giving economical medication
Antiepileptik : fenobarbital, fenilhidaatoin. This medication is divided to become 2 shares a. Medication of intermitten profilaksis To prevent recurred of spastic return, patient which suffering given by simple fever spastic of mixture drug of antikonvulsan and of antipiretika which must be passed to child if suffering fever again b. Long-Range Profilaksis Utilize him to guarantee there are dose him of terapeutik stable and enough in patient blood to prevent recurred of spastic later on day. Drug weared by is " Fenobarbital 4 - 5 mg / singk of BB / hr " sodium of Valproat / sour of valproat ( epilin, depakene) dose 20 - 3 0 mg/kgBW/day divided by 3 dose " Fenitoin ( dilantin). Medication of antikonvulsi at this long-range profilaksis continued at least 3 year like medication of epilepsy. Discontinuing medication of antikonvulsi later slow have to by way of lessening dose during 3 months or 6 months.
4. Searching and ask apology cause
Cause of good fever spastic of simple fever spastic and also epilepsy which is diprovikasi by fever usually Acute Infection Channel Exhalationand GRANDMOTHER.
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