Electronic Theses and Dissertation

ABSTRAK
Latar belakang Respon awal 3 bulan pertama terapi asam valproat merupakan faktor prognostik untuk memprediksi keberhasilan pengobatan. Terdapat beberapa faktor yang dapat memengaruhi respon awal terapi asam valproat diantaranya jenis kelamin, umur, riwayat keluarga dengan epilepsi, elektroensefalogram (EEG), ukuran kepala, tipe kejang, palsi serebral, dan frekuensi kejang sebelum terapi.
Tujuan Untuk mengetahui faktor risiko respon awal terapi asam valproat pada anak dengan epilepsi.
Metode Penelitian ini merupakan kohort retrospektif yang dilakukan pada anak yang baru terdiagnosis epilepsi. Data diambil dari rekam medis pasien berobat di Poliklinik Anak RSUD dr. Zainoel Abidin selama satu tahun. Respon awal buruk terapi asam valproat bila masih dijumpainya kejang selama 3 bulan pengobatan asam valproat.
Hasil Sebanyak 90 subjek dilibatkan dalam penelitian ini. Mayoritas berjenis kelamin lelaki sebesar 64,4%, yang berumur ≥3 tahun 87,8% dan 50% terdapat riwayat keluarga dengan epilepsi. Respon awal buruk terapi asam valproat pada penelitian ini 38,9%. Secara bivariat faktor risiko yang memengaruhi respon awal terapi asam valproat diantaranya umur, riwayat keluarga dengan epilepsi, elektroensefalogram, ukuran kepala, tipe kejang, palsi serebral dan frekuensi kejang sebelum terapi. Analisa multivariat didapatkan faktor risiko yang memengaruhi respon awal buruk terapi asam valproat pada anak dengan epilepsi terdiri dari palsi serebral (RR 62,62, IK95% 3,93 - 996,45), kejang fokal (RR 7,10, IK95% 1,15 -
43,80), riwayat keluarga dengan epilepsi (RR 6,58, IK95% 1,67-25,95),
elektroensefalogram abnormal (RR 5,27, IK95% 1,16 - 23,87).
Kesimpulan Faktor risiko yang paling memengaruhi respon awal buruk terapi asam valproat pada anak dengan epilepsi yaitu palsi serebral, kejang fokal, riwayat keluarga dengan epilepsi, dan elektroensefalogram abnormal.
Kata kunci: Epilepsi, faktor risiko, respon awal terapi asam valproat.

ABSTRACT Background The initial response in the first three months of valproic acid therapy is a prognostic factor in predicting treatment success. Several factors can influence the initial response to valproic acid therapy, including gender, age, family history of epilepsy, electroencephalogram (EEG), head circumference, type of seizure, cerebral palsy, and pre-therapy seizure frequency. Objective To determine the risk factors for early response to valproic acid therapy in children with epilepsy. Method This study is a retrospective cohort conducted in children newly diagnosed with epilepsy. Data were collected from medical records of patients seeking treatment at the Pediatric Polyclinic of dr. Zainoel Abidin Hospital for one year. The initial response to valproic acid therapy is considered poor if seizures persist during the three months of valproic acid treatment. Result This study involved 90 subjects. The majority were male 58 (64.4%) patients, aged three years or older 79 (87.8%) patients, and 45 (50%) patients had a family history of epilepsy. More than a quarter of the subjects 35 (38.9%) showed initial poor responses to valproic acid therapy. Based on the bivariate analysis, risk factors that affect the initial response to valproic acid therapy include age, family history of epilepsy, electroencephalogram, head circumference, seizure type, cerebral palsy, and pre-therapy seizure frequency. The result of the multivariate analysis shows that risk factors affecting poor initial response to valproic acid therapy in children with epilepsy include cerebral palsy (RR 62.62, CI95%: 3.93 - 996.45), focal seizures (RR 7.10, CI95%: 1,15 - 43.80), family history of epilepsy (RR 6.58, CI95%: 1.67-25.95), and abnormal electroencephalogram (RR 5.27, CI95%: 1.16 - 23.87). Conclusion The risk factors that primarily affect the poor initial response to valproic acid therapy in children with epilepsy include cerebral palsy, focal seizure, family history of epilepsy, and abnormal electroencephalogram. Keywords: Epilepsy, risk factors, initial response to valproic acid therapy.