6.

10 MACAM-MACAM : TREMOR, TICS,

WILSON’S DISEASE, KONDISI
PAROKSISMAL
TREMOR
• Tremor pada anak-anak  banyak etiologi 
>>> metabolik dan toksisitas obat
• Periode postpartum  muncul tremor yang
berlebihan (jitteriness) pada seluruh tubuh
• Tremor pada anak = tremor essential 
Dengan frekuensi 4-11 Hz yang melibatkan
tangan dan badan = responsif terhadap ethanol
TICS (Including Tourette Syndrome)

TICS

Complex Motor Complex Phonic

Touching Humming
Smelling Echolalia
Shaking Whistling
Jumping Singing
WILSON’S DISEASE

• Treatable movement disorder

• Hampir setengah dari seluruh pasien WD remaja

muncul gejala parkinsonism, tremor, ataksia,
titubation, chorea, kejang, dysarthria, dan
dystonia
KONDISI PAROKSISMAL

• Termasuk paroksismal dyskinesia, stereotypi,

benign paroxysmal torticollis, spasmus nutans

• Sandifer syndrome  GER dengan spastic

torticollis dan dystonic body movements
7. DIAGNOSIS
• Diagnosis :

1. Movement disorder  no aura no post ictal state

2. Relation to sleep  differentiate the type of movement

abnormality

3. Tics can be voluntarily suppressed, sometimes for

extended periods of time

4. Certain abnormalities may occur in attacks

• Routine blood tests  biochemistry, thyroid functions,
and ceruloplasmin are nearly always needed

• When a genetic or ongoing metabolic disease is

suspected, specific blood and urine testing, EEG and
structural/ functional brain imaging should be
performed according to the clinical context
8. TERAPI
9. KESIMPULAN
• The etiology and pathogenesis of several acquired conditions such
as PANDAS and TS is still obscure and should be pursued. More
important, double blind controlled clinical studies to evaluate and
delineate the best therapeutic approach to most of the conditions
described is still missing: what is the best therapy for TS? How
should tremor be approached and what is the optimal therapy of
tardive dyskinesia in children are examples of questions that should
be addressed
• Panduan untuk menghindari penggunaan agen yang dapat
menyebabkan movement disorders sebagai efek samping
sementara maupun permanen harus dikeluarkan.