Diagnosis Banding Kejang

Demam
Princesa S. Sitanggang
09-080
 Viral Ensefalitis
• Etiologi : virus mumps (ss RNA), virus measles
(ss RNA) dan virus varicella zoster (ds DNA).
• Gejala : demam akut, tanda leptomeningeal
(sakit kepala, kekakuan pada leher, dsb); tanda
neurologi : kejang, perubahan kesadaran (lesu,
bingung, stupor, koma); gangguan perilaku
dan berbicara.

http://emedicine.medscape.com/article/1166498-clinical
 Sinkop
• Dipicu nyeri akut, kecemasan, atau timbul
setelah dari posisi berbaring/ duduk
• Gejala : sadar -> tidak sadar ( kelelahan,
berkeringat, mual); sakit kepala/ inkontinensia
dengan kejang dan sinkop.
Features Seizure Syncope

Immediate precipitating factors Usually none Emotional stress, Valsalva, orthostatic

hypotension, cardiac etiologies

Premonitory symptoms None or aura (e.g., odd odor) Tiredness, nausea, diaphoresis, tunneling of
vision

Posture at onset Variable Usually erect

Transition to unconsciousness Often immediate Gradual over secondsa

Duration of unconsciousness Minutes Seconds

Duration of tonic or clonic movements 30–60 s Never more than 15 s

Facial appearance during event Cyanosis, frothing at mouth Pallor

Disorientation and sleepiness after event Many minutes to hours <5 min

Aching of muscles after event Often Sometimes

Biting of tongue Sometimes Rarely

Incontinence Sometimes Sometimes

Headache Sometimes Rarely

aMay be sudden with certain cardiac arrhythmias.

 Kejang Psikogenik
• Dipicu tekanan psikologik
• Gejala : side-to-side turning of the head,
gerakan gemetar yang asimetris pada tungkai,
kejang pada keempat ekstremitas tanpa
penurunan kesadaran, pelvic thrusting
• Berlangsung lebih lama
 Referensi
• Baumann, RJ. Febrile Seizure Differential
Diagnoses.
http://emedicine.medscape.com/article/1176
205-differential.
• Longo, DL., Kasper, DL., Jameson, JL., Fauci,
AS., Hauser, SL., Loscalzo, J. (2012) Principles
of internal medicine. Vol. I. Ed 18th