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A.

definition
Febrile seizures are seizures that occur in the increase in body temperature (a rectal temperature
above 380C) which is caused by a process ekstrakranium.
B. Etiology
A disease that most often cause febrile seizures are upper respiratory tract infections, acute otitis
media, pneumonia, bronchitis and urinary tract infections.
c. epidiomology
Febrile seizures occur in 2% - 4% of the population of children 6 months - 5 years.
80% is a simple febrile seizures,
20% of cases are complex febrile seizures.
The occurrence of febrile seizures depend on age, height and rapid temperature increases
d. classification
Febrile seizures are classified into:
1. Simple febrile seizures (Simple febrile seizures)
Febrile seizures are brief, less than 15 minutes, general tonic or clonic, generally will stop on its
own, without a focal movement or repeated within 24 hours.
2. complex febrile seizures (Complex febrile seizure)
1. Seizures of more than 15 minutes
2. The focal or partial seizures one side, or generalized seizures preceded partial seizures
3. Repeat or more than 1 time in 24 hours
e. patofisiology
To maintain living cells or organs of the brain, required an energy derived from the metabolism. The
raw material to metabolize the most important brain is glucose.
Under normal circumstances the cell membranes of neurons can be passed easily by a potassium ion
(K +) and very difficult to pass by sodium ions (Na +) and other electrolytes, except chloride ion
(Cl). As a result, the concentration of K + in neuronal cells of high and low concentrations of Na +
into the neuron cell while outside the reverse is the case. Due to differences in the type and
concentration of ions inside and outside the cell, then there is a potential difference is called the
membrane potential of neurons. To maintain the balance of energy required petensial this membrane
and the enzyme Na-K-ATPase which is found on the cell surface. Petensial balance these
membranes can be altered by the presence of:
1. Changes in extracellular ion concentrations diruang.
2. Stimulation of the arrival of a sudden, for example, mechanical, chemical or electrical flow from
the surroundings.
3. Amendment of the pathophysiology of the membrane itself due to disease or hereditary.

Each child has a seizure threshold which is different and depends on the high or low seizure threshold of a child suffering from seizures in certain body temperature rise.In the state of fever. Laboratory . seizures can already occur at a temperature of 38oC. whereas in children with a high seizure threshold. such as tonic-clonic attacks. After the seizures stop child looks tired. and in a short time can happen electricity potassium ion diffusion. Differential Diagnosis . 1oC rise would result in 10-15% increase in basal metabolism and oxygen demand will increase to 20%. j. Clinical manifestations temperature rises rapidly and usually develops when the body temperature reaches 390C or more (rectal).Infants less than 12 months is highly recommended to do .Babies over 18 months is not a routine When sure not menigitis are not clinically necessary lumbar puncture. In infants are often not obvious clinical manifestations. Seizures generally of short duration. In children with a low seizure threshold. sleepy.Not recommended routine laboratory tests can be examined to evaluate the source of infection or look for causes such as peripheral blood. Lumbar puncture CSF examination carried out to establish or rule out meningitis. a lumbar puncture is recommended to: . Remove the electric charge is so great that can be extended to the whole cell or membrane with the aid of his neighbors called neurotransmitters. electrolytes and blood sugar 2. Electroencephalography Examination of electroencephalography (EEG) can not predict the recurrence of seizures 4. So at a certain rise in body temperature can change the balance of the cell membrane of neurons. new seizures can occur at 40 ° C or more f. 3.Infants between 12-18 months recommended . not routine and the indication. asleep. and did not give any reaction for a moment or so-called short period of sleepy after a seizure. the child woke up and regain consciousness without neurological deficit. but after a few seconds or minutes. Imaging Photos x-ray imaging and neuro imaging such as computed tomography (CT) or magnetic resonance imaging (MRI) is rarely done. Often seizures stop on its own after receiving first aid. SUPPORTING INVESTIGATION 1. therefore. and there was a seizure.

Dose ibuprofen 5-10 mg / kg / time divided 3-4 doses CASE ILLUSTRATION Identity: Name: Fachrul Razi No. which is 12 hours after the initial dose. If seizures remain stopped given bolus intravenous phenytoin with an initial dose of 10-20 mg / kg / times with a speed of 1 mg / kg / min. weighing 20kg. phenobarbital 5-15 mg / kg / day intravenous bolus dose followed by 1-6 mg / kg / min drips or midazolam 0. When 2 times with diazepam rectal still seizures. 2015.5 mg / kg or rectal diazepam 5 mg for children weighing less than 10 kg and 10 mg for body weight over 10 kg.2 mg / kg followed by 0.3 to 0. Provision of drugs at the time of fever Antipyretics (paracetamol) is given at a dose of 10-15 mg / kg / times given 4 times per day and no more than 5 times.1 to 0. And here can be given diazepam intravenously at a dose of 0. When the seizure stops next dose is 5-7 mg / kg / day. TREATMENT If it comes in a state of spasm given diazepam rectal diazepam rectal dose is 0. Seizures are not stopped with rectal diazepam may be repeated again in the manner and with the same dose interval 5 minutes.Male Ethnicity: Indonesia Address: Cupak A male patient was 7 years old.4 mg / kg / hour. as many as 1 time for 10 minutes with foaming mouth froth. MR: 113 990 Age: 7 years Sex: Male . Anamnesa The main complaint: Seizures 2 hours before entering the Hospital History of present illness: Seizures 2 hours before hospital admission.5 mg / kg with an evaluation for 5 minutes. the eyes are not reversed and spasms throughout the body. the patient's high fever and headache Agency looks tired Decreased appetite since the last 1 day Cough and cold does not exist Regular bowel movements Regular urination .Inflammation of the lining of the brain (meningitis) Inflammation of the brain (encephalitis) Brain abscess k. Phenytoin if the seizure has not stopped. the patient should be treated in the intensive care unit. it is recommended to the hospital. came to the hospital ER solok on October 7. 1 day before entering the hospital.

thril no Percussion: heart boundaries within normal limits Auscultation: regular. Ears: no abnormality Nose: no abnormality Mouth: lips and oral mucosa moist.Past medical history: Previously children had experienced a seizure two years ago. spleen not palpable. no tenderness in the entire region of the abdomen Percussion: timpani Auscultation: bowel there are 5 x / min Extremity . tonsils T0-T0 Neck: no swollen lymph nodes Thoracic Pulmonary Inspection: symmetrical right and left in a state of static and dynamic Palpation: fremitus same tactile left and right Percussion: sonor Auscultation: vesicular. rhonki . wheezing ./ -. no jaundice Palpation: no palpable liver. sclera no jaundice. noisy no Abdomen Inspection: looks a little bulge. Physical examination General state: moderate Awareness: composmentis cooperative Blood pressure: 100/70 mmHg Nadi: 114 x / min Breath: 20 x / min Temperature: 38oC BB: 20 kg Head Size: normocephal Eyes: not anemic conjunctiva./ Heart Inspection: iktus cardiac invisible Palpation: cardiac iktus palpable in parallel linea mid clavikularis the left intercostal space V.

pathological reflexes .9% Leukocytes: 3. high-calorie foods Pharmacology: IVFD Ka-EN 3B 16 drops / minute Paracetamol syrup 3 x ½ inc Diazepam pulveres 3 x 1. does not appear edema. reflex physiological ++ / ++. reflex physiology + + / ++. pathological reflexes . good perfusion. good perfusion./ Genitalia: there is no abnormality Supporting investigation Routine blood Hb: 12.4 g% Ht: 35.000 / mm3 Working diagnosis: Seizures Fever Simplex Therapy Dietetic: high-protein.000 / mm3 Platelets: 218.Above: akral warm.5 mg phenytoin If still cramp drip ./ Below: akral warm.