Teknik anamnesis dan Pemeriksaan yang perlu dilakukan pada Kejang Anak!

Introduction

This tutorial provides a step-by-step guide on conducting anamnesis and examinations for children experiencing seizures. Understanding the necessary procedures and questions to ask can help in making an accurate diagnosis. This guide is based on insights from Dr. Ahmad Fachrurrozi, Sp.A, and is essential for healthcare professionals working with pediatric patients.

Step 1: Conducting Anamnesis

Gathering a thorough medical history is crucial. Follow these guidelines during the anamnesis:

• Patient Information:

  • Age and gender of the child.
  • Relevant family medical history, especially regarding seizures or neurological conditions.

• Seizure History:

  • Onset: When did the seizure start?
  • Duration: How long did the seizure last?
  • Frequency: How often do seizures occur?
  • Type: Describe the characteristics of the seizure (e.g., tonic-clonic, absence).

• Preceding Events:

  • Any noticeable triggers (fever, illness, stress).
  • Recent vaccinations or medications taken.

• Postictal State:

  • Observe any confusion, lethargy, or unusual behavior following the seizure.

• Developmental History:

  • Assess milestones and any developmental delays.

Step 2: Performing a Physical Examination

A systematic physical examination can help identify underlying issues. Follow these steps:

• General Appearance:

  • Note the child’s responsiveness and overall condition.

• Neurological Examination:

  • Check for any focal neurological deficits.
  • Assess reflexes, muscle strength, and coordination.

• Vital Signs:

  • Monitor temperature, heart rate, and respiratory rate.

• Head and Neck Examination:

  • Look for signs of trauma or infection in the head area.

• Cardiovascular and Respiratory Assessment:

  • Listen for any abnormal heart sounds or breathing issues.

Step 3: Laboratory and Diagnostic Tests

Depending on initial findings, certain tests may be necessary to aid in diagnosis:

• Blood Tests:

  • Complete blood count to check for infection.
  • Electrolytes to assess for imbalances.

• Imaging Studies:

  • Consider a CT scan or MRI if structural abnormalities are suspected.

• Electroencephalogram (EEG):

  • This test is vital for assessing the electrical activity in the brain and can help identify seizure types.

Step 4: Discussion with Caregivers

Communicate findings and potential next steps with the child’s caregivers:

• Explain Findings: Clearly outline the results of anamnesis and examinations.
• Discuss Possible Diagnoses: Share any provisional diagnoses based on the information gathered.
• Next Steps: Talk about further testing or referrals needed.

Conclusion

Effective anamnesis and examination are key in managing pediatric seizures. By systematically gathering information, performing thorough examinations, and communicating clearly with caregivers, healthcare professionals can significantly improve outcomes for children experiencing seizures. Always ensure to stay updated with the latest guidelines and practices in pediatric care.