Terapi Antikejang Tunggal dan Kombinasi pada Epilepsi Anak: Literature Review
DOI:
https://doi.org/10.59435/gjik.v4i2.2200Keywords:
epilepsi anak, frekuensi kejang, Kualitas Hidup, terapi kombinasi, terapi tunggalAbstract
Epilepsi anak membutuhkan tata laksana farmakologis jangka panjang yang bertujuan menurunkan frekuensi kejang dengan efek samping seminimal mungkin. Terapi antikejang tunggal umumnya dipilih sebagai strategi awal karena regimen lebih sederhana, evaluasi respons lebih jelas, dan risiko interaksi obat lebih rendah. Namun, sebagian anak tetap mengalami kejang meskipun telah mendapat terapi awal yang adekuat, sehingga terapi kombinasi diperlukan pada kasus tertentu. Tinjauan literatur ini bertujuan menganalisis peran terapi antikejang tunggal dan kombinasi pada epilepsi anak, khususnya terkait frekuensi kejang, keamanan, kepatuhan, dan kualitas hidup. Metode disusun menggunakan kerangka PICO dan alur seleksi berbasis PRISMA. Penelusuran literatur dilakukan melalui PubMed, ScienceDirect, Google Scholar, Cochrane Library, dan laman pedoman klinis resmi untuk publikasi tahun 2021-2026. Sebanyak 14 artikel dan dokumen pedoman memenuhi kriteria kelayakan dan disintesis secara naratif. Hasil kajian menunjukkan bahwa terapi antikejang tunggal tetap rasional sebagai pendekatan lini awal, sedangkan terapi kombinasi lebih tepat dipahami sebagai eskalasi terapi pada anak dengan kontrol kejang belum optimal. Perbedaan frekuensi kejang antara kedua kelompok terapi harus ditafsirkan dengan mempertimbangkan tipe kejang, etiologi, durasi penyakit, kepatuhan, komorbiditas, riwayat kegagalan terapi, dan derajat keparahan awal.
References
Almomani, M. A., Almomani, B. A., Banikhaled, R. B., Elayyan, R. N., Abu Abbas, Y. H., Al Thiabat, H., & Al-Qudah, H. (2025). Epilepsy in children: Quality of life and disease control. Frontiers in Neurology, 16, 1692379. https://doi.org/10.3389/fneur.2025.1692379
Armide, N., & Babaei, M. (2025). Anti-seizure medication induced cognitive impairment in children with epilepsy: A narrative review. Iranian Journal of Child Neurology, 19(2), 9-25. https://doi.org/10.22037/ijcn.v19i2.46371
Auvin, S., & Specchio, N. (2024). Pharmacotherapeutic strategies for drug-resistant epilepsy in children. Epilepsy & Behavior, 161, 110139. https://doi.org/10.1016/j.yebeh.2024.110139
De Bellis, M., Carboni, M., De Sarro, G., Russo, E., & Citraro, R. (2025). Adverse effects of antiseizure medications: A review of the impact of pharmacogenetics and drugs interactions in clinical practice. Frontiers in Pharmacology, 16, 1584566. https://doi.org/10.3389/fphar.2025.1584566
Gencpinar, P., Arican, P., Olgac Dundar, N., Kilic, B., Sarigecili, E., Okuyaz, C., Aydin, K., & Tekgul, H. (2025). First-drug efficacy and drug-resistant epilepsy rates in children with new-onset epilepsies: A multicenter large cohort study. Journal of Child Neurology, 40(1), 5-9. https://doi.org/10.1177/08830738241283711
Li, C., Wang, X., Deng, M., Luo, Q., Yang, C., Gu, Z., Lin, S., Luo, Y., Chen, L., Li, Y., & He, B. (2025). Antiepileptic drug combinations for epilepsy: Mechanisms, clinical strategies, and future prospects. International Journal of Molecular Sciences, 26(9), 4035. https://doi.org/10.3390/ijms26094035
National Institute for Health and Care Excellence. (2025). Epilepsies in children, young people and adults: NICE guideline NG217. https://www.nice.org.uk/guidance/ng217
Nevitt, S. J., Sudell, M., Weston, J., Tudur Smith, C., & Marson, A. G. (2022). Antiepileptic drug monotherapy for epilepsy: A network meta-analysis of individual participant data. Cochrane Database of Systematic Reviews, 4(4), CD011412. https://doi.org/10.1002/14651858.CD011412.pub4
Peng, Q., Ma, M., Gu, X., Hu, Y., & Zhou, B. (2021). Evaluation of factors impacting the efficacy of single or combination therapies of valproic acid, carbamazepine, and oxcarbazepine: A longitudinal observation study. Frontiers in Pharmacology, 12, 641512. https://doi.org/10.3389/fphar.2021.641512
Perdani, R. R. W., Arozal, W., Mangunatmadja, I., Kaswandani, N., Handryastuti, S., Medise, B. E., Hardi, H., Thandavarayan, R. A., & Oswari, H. (2023). The efficacy and safety of first-line anti-seizure medications as substitution therapy for children with drug-resistant epilepsy: A randomized controlled trial protocol. Frontiers in Neurology, 14, 1237183. https://doi.org/10.3389/fneur.2023.1237183
Perdani, R. R. W., Arozal, W., Mangunatmadja, I., Kaswandani, N., Handryastuti, S., Medise, B. E., Wardani, A. S., Thandavarayan, R. A., Oswari, H., & Lee, H. J. (2025). Therapeutic reassessment of first-line antiepileptic drugs in pediatric patients unresponsive to second-line agents: A randomized trial in Jakarta. Paediatrica Indonesiana, 65(6), 496-508. https://doi.org/10.14238/pi65.6.2025.496-508
Perucca, E., French, J. A., & Bialer, M. (2024). Which terms should be used to describe medications used in the treatment of seizure disorders? An ILAE position paper. Epilepsia, 65(3), 533-541. https://doi.org/10.1111/epi.17877
Sultana, B., Panzini, M. A., Veilleux Carpentier, A., Comtois, J., Rioux, B., Gore, G., Bauer, P. R., Kwon, C. S., Jette, N., Josephson, C. B., Keezer, M. R., & Perry, M. S. (2021). Incidence and prevalence of drug-resistant epilepsy: A systematic review and meta-analysis. Neurology, 96(17), 805-817. https://doi.org/10.1212/WNL.0000000000011839
World Health Organization. (2024). Epilepsy. https://www.who.int/news-room/fact-sheets/detail/epilepsy
Zerihun, T. E., Dagnew, F. N., Anberbr, S. S., & Tarekegn, G. Y. (2025). Determinants of uncontrolled seizures among pediatric epilepsy patients in Debre Tabor comprehensive specialized hospitals Ethiopia. BMC Pediatrics, 25, 552. https://doi.org/10.1186/s12887-025-05989-8
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