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Prastiya Indra Gunawan
Departemen Ilmu Kesehatan Masyarakat, Fakultas Kedokteran Unversitas Airlangga Surabaya
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Journal : Universa Medicina

 1 
Topiramate sprinkle is effective in the treatment of childhood epilepsy Gunawan, Prastiya Indra; Suharso, Darto
Universa Medicina Vol 31, No 1 (2012)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2012.v31.34-42

Abstract

BackgroundEpilepsy remains one of the most frequently occurring pediatric problems. Approximately 10-15% patients do not respond to conventional therapy. Topiramate as a novel antiepileptic drug has a broad spectrum activity, presumably indicative of multiple anti-seizure mechanisms. Previous studies of topiramate as adjunctive and monotherapy in adults have shown beneficial effects. The objective of this research was to evaluate the efficacy and tolerability of topiramate sprinkle monotherapy in pediatric epilepsy.MethodsThis experimental research was conducted in the Pediatric Neurology outpatient clinic department, Soetomo hospital, Surabaya, involving 18 consecutive subjects. Subjects meeting the inclusion criteria were treated with topiramate sprinkle adjusted dose. Seizure frequency and side effects were observed in weeks 1, 4, 8, 12, 16, 20 and 24, respectively. Electro encephalogram (EEG) and laboratory examinations were performed prior to and after 6 months of treatment. The t-test for related samples and McNemar test were utilized for statistical analysis. ResultsA total of 15 subjects completed the study. Topiramate-treated patients showed a statistically significant difference of seizure frequency reduction from 2.7 ± 1.16 to 0.13 ± 0.51 (p=0.000) with 93.7% patients being seizure free in 20 weeks. EEG recordings did not differ statistically in decrement of epileptiform activity in 20% subjects. About 7% subjects developed drowsiness and 33.3% subjects suffered from appetite suppression in the initial treatment. Laboratory results showed no abnormalities. ConclusionsThere was reduction of seizure frequency and no EEG recording alterations after topiramate sprinkle monotherapy. Topiramate as a monotherapy is highly effcicacious in childhood epilepsy.
Seizure increases electroencephalographic abnormalities in children with tuberculous meningitis Gunawan, Prastiya Indra; Saharso, Darto
Universa Medicina Vol 34, No 3 (2015)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2015.v34.161-167

Abstract

BackgroundTuberculous meningitis (TBM) is a severe intracranial infection with fatal outcomes, permanent disabilities, and electroencephalographic (EEG) abnormalities. Seizures may occur in TBM. The EEG findings in TBM vary according to the site of the inflammatory process. There are few studies describing the EEG patterns and clinical manifestations of TBM. The objective of this study was to investigate the correlation between clinical findings and EEG patterns in children with TBM. MethodsA study of cross-sectional design using medical records was conducted on 12 children with TBM, with their EEG patterns classified as abnormal and normal. Clinical manifestations such as seizures, altered consciousness, headache or fever were collected. A positive cerebrospinal fluids Mycobacterium tuberculosis culture was considered to indicate definitive TBM. Abnormal EEG descriptions were classified into abnormal I, II or III. Correlation between EEG pattern and clinical manifestation were analyzed with Fisher’s exact test. ResultsThe study found cases of 12 children with TBM, the majority presenting with seizures, decreased consciousness and fever. Abnormal EEGs were found in 75% of children and 77% of them showed epileptogenic activities. The EEG results mostly described epileptogenic potentials in the frontotemporal region. There was a significant correlation between EEG abnormality and seizures in children with TBM (p<0.05).ConclusionsThe EEG pattern in children with TBM varies, and EEG abnormalities were more frequently localized in the frontotemporal region. Seizures were associated with EEG abnormalities in children with TBM. EEG abnormalities occurring simultaneously with seizures may predict the occurrence of seizures.
Age decreases quality of life in adolescents with intractable epilepsy Prastiya Indra Gunawan; Theresa Laura Limanto; Darto Suharso
Universa Medicina Vol. 34 No. 2 (2015)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2015.v34.104-111

Abstract

BackgroundIntractable epilepsy considerably affects both the private and social life of the patient. The objective of this study was to determine the quality of life of intractable epileptic adolescents and its correlated factors. Methods A cross sectional study was conducted in the Pediatric Neurology outpatient clinic of Dr. Soetomo Hospital. All intractable epileptic adolescents aged between 10 to 16 years were asked to complete a questionnaire on quality of life in epilepsy for adolescents (QOLIE-AD-48). A multiple linear regression was used to analyze the data through SPSS v17.0.ResultsThirty one patients with mean age of 12.41 ± 1.40 years were enrolled in the study. The mean duration of diagnosed intractable epilepsy was 6.12 ± 4.30 years. Mean score for impact of epilepsy was 57.11 ± 24.50, for memory and concentration 53.54 ± 26.66, physical functioning 65.56 ± 23.67, social stigma 52.23 ± 17.48, social support 52.64 ± 22.69, behavior at school 57.51 ± 26.50, attitude 53.40 ± 16.70 and health perception 61.51 ± 11.30. Multiple linear regression results showed that quality of life (QOL) was not significantly correlated with duration of epilepsy, sex and nutritional status (p>0.05), but increasing age was significantly decreases quality of life (p<0.05). ConclusionsIntractable epileptic adolescents have higher scores for physical functioning and health perception, but lower scores for social stigmatization. Social support has extremely low scores. Increasing age decreases quality of life in adolescents with intractable epilepsy.
Co-Authors Abdurachman Abdurachman Adinda Chairunnisa Aditiawarman Aditiawarman, Aditiawarman Agus Sulistyono Alfira Nailatul Izzah Aminuddin Harahap Andriati Andriati Arina Setyaningtyas Arinda Putri Auna Vanadia Avida Marisa Ilmi Basyarahil, Rayhan Muhammad Budi Utomo Darto Saharso Darto Suharso Darto Suharso, Darto Denisa Dwi Rahmayani Dwiyanti Puspitasari, Dwiyanti DYAH FAUZIAH, DYAH Faroek Hoesin Felice, Calista Florentina Sustini Hanik Badriyah Hidayati,* Mohammad Hasan Machfoed,* Kuntoro,** Soetojo,*** Budi Santoso,**** Suroto,***** Budi Utomo****** Heru Setiawan Indri Wahyuni Irwanto, Irwanto Islamiyah, Wardah Rahmatul Kanti Ismayani Lourin Nova Martono Tri Utomo Mohammad Aldika Akbar Mohammad Nata Ardiansyah Mohammad Sjaifullah Noer Muhammad Rizki Darmawan M Nabila Annisa Harum Nabila Fitri Ariyati Ni Wayan Tirthaningsih Ninik Asmaningsih Soemyarso Noviandi, Riza Nuramalia, Lady Sherly Parenrengi, Muhammad Arifin Prastyani, Reni Pravita Tri Andrianti Ratih Dwi Andini Risky Vitria Prasetyo Riza Noviandi Riza Noviandi Riza Noviandi Romdhoni, Achmad Chusnu Rozalina Loebis, Rozalina Samosir, Sunny Mariana Sri Andreani Utomo, Sri Andreani Sunny Mariana Samosir Sunny Mariana Samosir Theresa Laura Limanto Viskasari P. Kalanjati wihasto suryaningtyas Wirawan, Putu Tanisya Putri Zhafira, Dinda