Pola Pengobatan dan Fungsi Kognitif Pasien Epilepsi di RSJ Mutiara Sukma


  • Herpan Syafii Harahap Fakultas Kedokteran Universitas Mataram
  • Yanna - Indrayana Fakultas Kedokteran Universitas Mataram
  • Emmy - Amalia Fakultas Kedokteran Universitas Mataram




Epilepsi, gangguan fungsi kognitif, obat antiepilepsi


Epilepsi merupakan suatu gangguan pada sistem saraf pusat yang memiliki dampak neurobiologik, kognitif, psikologik, dan sosial. Penggunaan obat antiepilepsi diperlukan untuk mencegah komplikasi yang ditimbulkan oleh epilepsi. Salah satu komplikasi penting dari epilepsi adalah terjadinya gangguan fungsi kognitif. Penelitian ini bertujuan untuk mengetahui gambaran pola pengobatan dan fungsi kognitif pasien epilepsi di RSJ Mutiara Sukma Provinsi NTB. Sebanyak 97 subjek dilibatkan dalam penelitian potong lintang dengan pengambilan data meliputi usia, jenis kelamin, usia awitan bangkitan, tipe bangkitan, etiologi bangkitan, dan obat antiepilepsi yang digunakan. Fungsi kognitif dari 45 subjek penelitian diperiksa menggunakan instrumen MoCA-INA dan TMT-B. Perbandingan antara jenis OAE yang digunakan dan jumlah subjek dengan gangguan fungsi kognitif dianalisis dengan uji statistik Kai-kuadrat. Hasil penelitian menunjukkan 80,4% subjek mendapatkan monoterapi OAE. Monoterapi yang digunakan antara lain fenitoin (30,9%), karbamazepin (27,8%), dan asam valproat (21,7%). Pada pemeriksaan MoCA-INA, 100% subjek mengalami gangguan fungsi kognitif. Pada pemeriksaan TMT-B, 91,11% subjek memiliki hasil pemeriksaan tidak normal. Tidak terdapat perbedaan jumlah subjek dengan gangguan fungsi kognitif yang bermakna diantara berbagai kelompok yang mendapatkan OAE berbeda (p=0,304). Dapat disimpulkan bahwa sebagian besar pasien epilepsi di RS ini mendapatkan monoterapi OAE fenitoin, mengalami gangguan fungsi kognitif terutama pada domain atensi dan fungsi eksekutif dan tidak ditemukan perbedaan antar jenis pengobatan. 


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Author Biographies

Herpan Syafii Harahap, Fakultas Kedokteran Universitas Mataram

Neurology department

Yanna - Indrayana, Fakultas Kedokteran Universitas Mataram

Cardiology Department

Emmy - Amalia, Fakultas Kedokteran Universitas Mataram

Psychiatry Department


Fisher RS, Acevedo C, Arzimanoglou A, et al. ILAE Official Report: A Practical Clinical Definition of Epilepsy. Epilepsia. 2014; 55(4): 475-482.

Shakirullah, Ali N, Khan A, and Nabi M. The Prevalence, Incidence, and Etiology of Epilepsy. International Journal of Clinical and Experimental Neurology. 2014; 2(2): 29-39.

Ngugi AK, Bottomley C, Kleinschmidt I, Sander JW, and Newton CR. Estimation of the Burden of Active and Life-time Epilepsy: A Meta-Analytic Approach. Epilepsia. 2010; 51(5): 883-890.

Russ SA, Larson K, and Halfon N. A National Profile of Childhood Epilepsy and Seizure Disorder. Pediatrics. 2012; 129(2): 256-264.

Bell GS, Neligan A, and Sander JW. An Unknown Quantity – The Worldwide Prevalence of Epilepsy. Epilepsia. 2014; 55(7): 958-962.

Tellez-Zenteno JF and Hernandez-Ronquillo L. A Review of the Epidemiology of Temporal Lobe Epilepsy. Epilepsy Research and Treatment. 2012; 2012: 1-5.

Komite Peningkatan Mutu dan Keselamatan Pasien RSJ Mutiara Sukma. Laporan Program Kerja Tahun 2015-2016. Mataram: RSJ Mutiara Sukma; 2016.

Berg AT and Scheffer IE. New Concepts in Classification of the Epilepsy: Entering the 21st Century. Epilepsia. 2011; 52(6): 1058-1062.

Wong M. Juvenile Myoclonic Epilepsy: Is It An Idiopathic Epilepsy Caused by a Malformation of Cortical Development? Epilepsy Currents. 2010; 10(3): 69-71.

Shorvon SD. The Etiologic Classification of Epilepsy. Epilepsia. 2011; 52(6): 1052-1057.

Glauser T, Ben-Menachem E, Bourgeois B, et al. Updated ILAE Evidence Review of Antiepileptic Drug Efficacy and Effectiveness as Initial Monotherapy for Epileptic Seizures and Syndromes. Epilepsia. 2013; 54(3): 551-563.

Helmstaedter C. The Impact of Epilepsy on Cognitive Function (Abstract). Journal of Neurology Neurosurgery Psychiatry. 2013; 84: e1.

Guzeva VI, Belash VO, Guseva VV, Guzeva OV, and Anastazi IEO. Characteristics of Cognitive Functions in Children with Epilepsy. Neuroscience and Behavioral Physiology. 2009; 39(9): 885-889.

Nehra A, Tripathi M, Bhatia R, et al. Is Epilepsy a Cause of Cognitive Decline in Developing Brain. Activitas Nervosa Superior. 2013; 55(3): 112-117.

Hermann B, Seidenberg M, Sager M, et al. Growing Old with Epilepsy: The Neglected Issue of Cognitive and Brain Health in Aging and Elder Persons with Chronic Epilepsy. Epilepsia. 2008; 49(5): 731-740.

Guilhoto LMFF, Fernandes RDC, Pacheco SP, Ballester D, and Gilio AE. Benign Focal Seizures of Adolescence and Neuropsychological Findings in Patients from Community. Journal of Epilepsy Clinical Neurophysiology. 2009; 15(4): 184-191.

Witt JA and Helmstaedter C. Should Cognition be Screened in New-Onset Epilepsies? A Study in 247 Untreated Patients. Journal of Neurology. 2012; 259(8): 1727-1731.

Azizova RB. New Aspects of the Pathogenesis of Epilepsy. European Medical, Health and Pharmaceutical Journal. 2014; 7(2): 3-5.

Witt JA and Helmstaedter C. Monitoring the Cognitive Effects of Antiepileptic Pharmacotherapy – Approaching the Individual Patient. Epilepsy Behavior. 2013; 26(3): 450-456.

Asadi-Pooya AA, Emami M, and Sperling MR. Age of Onset in Idiopathic (Genetic) Generalized Epilepsies: Clinical and EEG Findings in Various Age Groups. Seizure. 2012; 21(6): 417-421.

Phabphal K and Kanjanasatien J. Montreal Cognitive Assessment in Cryptogenic Epilepsy Patients with Normal Mini-mental State Examination Scores. Epileptic Disorders. 2011; 13(4): 375-381.

Salthouse TA. What Cognitive Abilities are Involved in Trail-making Performance? Intelligence. 2011; 39(4): 222-232.

Zuo L, Dong Y, Zhu R, et al. Screening for Cognitive Impairment with the Montreal Cognitive Assessment in Chinese Patients with Acute Mild Stroke and Transient Ischemic Attack: A Validation Study. British Medical Journal Open. 2016; 6(7): e011310.

Prasetyo BT, Lumempouw SF, Ramli Y, dan Herqutanto. Nilai Normal Montreal Cognitive Assessement Versi Indonesia (MoCA-INA). Neurona. 2011; 29(1): 5-13.

Kelompok Studi Fungsi Luhur. Panduan Pemeriksaan Neurologi dan Neurobehavior. Jakarta: PERDOSSI; 2010; hal. 1-12.

Sarhan E, Walker MC, and Selai C. Evidence for Efficacy of Combination of Antiepileptic Drugs in Treatment of Epilepsy. Journal of Neurology Research. 2015; 5(6): 267-276.

Simargul B, Atli O, and Ilgin S. The Effect of Combination Therapy on the Plasma Concentrations of Traditional Antiepileptics: A Retrospective Study. Human and Experimental Toxicology. 2012; 31(10): 971-980.

Naithani M. The Conventional Antiepileptic Drug Use When Compared to a Combination Therapy Regime in a Teaching Hospital in India. International Journal of Pharma and Bio Sciences. 2012; 3(1): 191-197.

Lee JW and Dworetzky B. Rational Polytherapy with Antiepileptic Drugs. Pharmaceuticals. 2010; 3(8): 2362-2379.

Lin JJ, Mula M, and Hermann BP. Uncovering the Neurobehavioural Comorbidities of Epilepsy Over the Lifespan. The Lancet. 2012; 380: 1180-1192.

Dong Y, Sharma VK, Chan BP, et al. The Montreal Cognitive Assessment (MoCA) is Superior to the Mini-Mental State Examination (MMSE) for the Detection of Vascular Cognitive Impairment after Acute Stroke. Journal of the Neurological Sciences 2010; 299(1-2): 15-18.

Sanchez-Cubillo I, Perianez JA, Adrover-Roig D, et al. Construct Validity of The Trail Making Test: Role of Task-Switching, Working Memory, Inhibition/Interference Control, and Visuomotor Abilities. Journal of the International Neuropsychological Society. 2009; 15(3): 438-450.

Liik M, Vahter L, Gross-Paju K, and Haldre S. Cognitive Profile and Depressive Symptoms in Patients with Epilepsy. Medicina (Kaunas). 2013; 49(6): 254-261.






Research Article