Page 342 - Abstract Book KONIKA 18

Neurology

P-NEU-011
Spondylitis Tuberculosis in Adolescent with Disseminated Tuberculosis:
A Case Report

Pebriansyah, Setyo Handryastuti, Nastiti Kaswandani
Department of Child Health, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital,
Jakarta, Indonesia

Abstract
Background Spondylitis tuberculosis is one of the most common extrapulmonary tuberculosis following
disseminated tuberculosis. Clinical manifestations are heterogeneous and insidious. If left untreated, it could
lead into severe neurological deficits resulting poor quality of life and became a national burden in the future.
Objective To demonstrate diagnostic approach and comprehensive management of spondylitis tuberculosis
in adolescent with disseminated tuberculosis. Case A 16-year-old boy was admitted with a chief complaint
of abdominal distention and back pain two weeks before admission. Following months, he was kyphotic,
paralyzed and numb in both legs, and incapable of urination. The patient had enlargement of lymph nodes
(3.5x3.5 cm) on the neck and had been ruptured five months ago, mild pain and bent of the backbone, and
loss significant bodyweight. No history of trauma or tuberculosis in the family. On physical examination, he
was parestesis and paraplegia in both lower extremities, sclofuroderma was already dried and necrotic, and
kyphotic and gibbus formation around posterior thoracalis. Supportive examinations found destruction and
fusion resulting moderate spondylolisthesis, abscess with kyphotic formation, multiple tuberculoma in the
brain, and bilateral reticulonodular infiltrate suggestive tuberculosis of the lung. Managements consisted of
anti-tuberculous agent and surgery. Conclusion There are several variations in systemic and also neurologic
symptoms in spondylitis tuberculosis patient. The prognosis influenced by the patient’s age, the severity
of kyphosis deformity, the amount of vertebrae involvement, the site of the lesion and the patient’s health
status, such as nutritional status and other comorbidities.
Keywords: adolescen; spondylitis tuberculosis; disseminated tuberculosis

P-NEU-012
Risk Factors of Epilepsy and Generalized Epilepsy with Febrile Seizures Plus
associated with Systemic Complications and Developmental Disorders:
A Case Report

Egi Azhar Rafsanjani, Irwanto
Klinik Sabil, Departement of Child Health, Faculty of Medicine Universitas Airlangga,
Surabaya, East Java, Indonesia

Abstract
Background Epilepsy has various risk factors. Each of these risk factors increases the incidence of epilepsy
by 4%-6% while the combination of these risk factors will increase the incidence of epilepsy by 10%-49%.
There are about 10-20% of people with epilepsy will experience at least one episode of status epilepticus
which can cause systemic complications and possible future complications such as developmental disorders.
Objective To show the connection between the risk factors of epilepsy and the incidence of generalized
epilepsy with febrile seizures plus (GEFS+) in relation to its future complications. Case An 8-year-old boy
came to the hospital after experiencing a seizure during fever. He had first history of febrile seizures at the
age of 3 months and at the age of 4 years he had a seizure without fever and started taking anti-epileptic
drugs. He had a history of ventriculoperitoneal shunt procedures due to hydrocephalus. He has cerebral
palsy and global developmental delay. On physical examination, there was atrophy and hypotonia on the
right and left legs. His brother also have epilepsy. General management of epilepsy has shown good clinical
results in this case. Conclusion It is important to find out the cause of seizures in epilepsy and GEFS+ to
avoid systemic complications.
Keywords: developmental disorder; epilepsy; GEFS+; risk factors of epilepsy; status epilepticus

294 KONIKA XVIII Abstract Book