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8/20/2019 Prosedur Diagnostik neuroooo
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KMI 1
PROSEDUR DIAGNOSTIK
Dr.YUNELDI ANWAR, SpSBAG. NEUROLOGI FK USU
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KMI 2
PROSEDUR DIAGNOSTIK
• PEM. LABORATORIUM.• FOTO RONTGEN :
SCHEDULE FOTO.
SERVIKAL : AP, LAT, OBLIQ. THORAKAL: AP, LAT.
LUMBOSAKRAL: AP, LAT, OBLIQ.
• CT SCAN, MRI, MRA, PET, SPECT, DLL.• LUMBAL PUNGSI.
• EEG, EMG, EVOKE POTENSIAL, DLL.
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KMI 3
NEURO IMAGING
• STRUKTURAL / ANATOMIS CT
SCAN , MRI, MYELOGRAFI, DLL.
• FUNGSIONAL EEG, EMG, EVOKEPOTENSIAL.
• METABOLISME PET, SPECT.
• BLOOD VASCULATURE : ANGIOGRAFI.
MR ANGIOGRAFI.
8/20/2019 Prosedur Diagnostik neuroooo
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KMI 4
LUMBAL PUNGSI
INDIKASI : Diag!"i" #$igi%i", $"$&a'i%i" (a
i&'a#a"i pa(a pa(a )aira "pia' 'ai*a.
P$r(ara+a "- ara)+!i(, i%ra "$r$-ra'.
M$ig$a' ar"i!#a%!"i".
M$gr %$aa i%ra raia'.
P$#-$ria $#!%$rapi i%ra%+$)a'.
Draia"$ / r$("i )aira 'i!r, "$p$r%i
pa(a +i(r!"$&a'" )!##!i)a.
M$g$%a+i r$"p! %$rapi #$igi%i" / 'ai*a.
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KMI 5
K!%ra i(ia"i L#-a' Pg"i
• D!"#$ %&''##$' '()$ *)$'$+ * SOL
()$'(&'()$+ -&)'$.
• I'/&* +*$+ !&*"0(".
• K$!$) ()10( 4..
• P)()10' (1& 5 .
• P&'$*( 6 #$'# 7$'("'#, %&)'$/$$' # 0&)$(.• D!"#$ $!$ +& 1$$ %$!$ %'$+ *)!,
"'("* ' %&)+" LP $'# !*"( 1&+#)$/.
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KMI 8
K!#p'ia"i L#-a' Pg"i
S$*( *&%$+$ 9%( +"10$+ %"'(")& -&$!$-&;.
H&1$(1$ &%!")$+ 6 "0!")$+.
I'/&*.
H&)'$.
T)$"1$( ($%.
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KMI <
CARA LUMBAL PUNGSI
• P$&' !0$)'#*$' )$($ %$!$ %'##) (&1%$(
(!") !#' % 1)'#, +&-&) = 0$!$' = %$-$
= +"("( FLEKSI.
• L*$ LP 0$$'$ %$!$ L4>L5 9&(&'($'#SIAS ;, 0+&- 7"#$ %$!$ L2>L3.
• K"+( !0&)-*$' !#' 7!"1 0+$ !&'#$'
$+*-+.
• ?$)"1 &7$7$) !#' #$) (+# 0&+$*$'# !&'#$'
"!"( @ = 2 !&)7$( $)$- *&%$+$.
8/20/2019 Prosedur Diagnostik neuroooo
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KMI
ELEKTRO ENSEFALOGRAFI
EEG 0
• EEG $!$+$- #$10$)$' $*(($ +()* ($* $($"
%(&'$+ +()* ($*.
•G)$/* $'# 1&'##$10$)*$' %&)0$-$' %(&'$+ +()* ($* E+&*()&'&/$+#)$1.
• P)&!") %&10"$($' #)$/*
E'$%r!$"$&a'!gra&i.
• S"10&) #&+10$'# EEG KORTEK,
(-$+$1" !$' /)1$( )&(*"+$) !$%$(
1&1%&'#$)"-'$.
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KMI
INDIKASI EEG
• D$#' *+$/*$ *&7$'#.
• E'&/$+%$(, E'&/$+(.
• B)$' !&$(-.• P&'#"*")$' %)#' *&7$'#.
• D&(&* +& ($* ()"*(")$+ ("1) &)&0),
()$"1$ *$%(.• G$'##"$' 1&($0+*, /+#* ! ($*.
• DLL.
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KMI @
PRINSIP PENILAIAN EEG
• EEG BUKAN ALAT DIAGNOSTIK
YANG MUTLAK.
• DAPAT DI?UMPAI :
EEG ')1$+ >>> K+' $0')1$+.
EEG $0')1$+ >>> K+' ')1$+.• YANG PENTING KORELASI DENGAN
KLINIS.
8/20/2019 Prosedur Diagnostik neuroooo
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KMI @@
DASAR INTERPRETASI
DASAR1DASAR ANALISA EEG :
U1"), *&$!$$' *+', %&1$*$$' 0$(,
'!*$ EEG.
K1% #+0# EEG !$' (%#)$/'$.
G$10$)$' EEG 1&() 6 $1&().
P&)"0$-$' $*(($ EEG &+$1$ )&*$1$'
!&'#$' $!$'$ (1"+" !$' %&)"0$-$'
*&$!$)$' 91&'#$'("*, (!"), PS, HV;.
A!$'$ #&+10$'# $0')+1$+ %(, %*&, !++.
8/20/2019 Prosedur Diagnostik neuroooo
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KMI @2
GELOMBANG1GELOMBANG EEG
P$)$1&(&) "($1$ -"0"'#$' /)&*&' 6+($&.
M$$1>1$$1 #&+10$'# :
A+/$ : = @3 %!, $'$* +$'7"(, !&$$, 1$($
(&)("("%.
B&($ : @4 %!, 25 "V, /)'($+. T&($ : 4 = < %!, 1&'#$'("*, (!").
D&+($ : 4 %!, (!"), $!$) $0')1$+.
S%*& : 2< =
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KMI @3
Ga#-ara EEG A-!r#a'
GAMBARAN ABNORMAL SPESIFIK :
S%*& *1%+&*, 3 %!, !//"& 0+$(&)$+,
'*)' !$' 1&() 9P&(( 1$+;.
S%*& $&, 0+$(&)$+,'*)' !$' !//"&
9G)$'!1$+ !%$(;.
GAMBARAN ABNORMAL NON SPESIFIK :
T"1) ($* %&)+$10$($' /*$+, D&+($.
T)$"1$ *$%( %&)+$10$($', %&'")"'$'
+($& !//"&, &"$ +"$'$ +&.
M&''#(,&'&/$+(,1&($0+* &'&/$+%$(.
8/20/2019 Prosedur Diagnostik neuroooo
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KMI @4
TINDAKAN PROVOKASI
• S"$(" ('!$*$' "'("* 1&)$'#$'#
(10"+'$ $*(($ EEG $0')1$+, !$%$(
0&)"%$ :
S(1"+" /(*.
H%&)&'(+$. R&*$1$' (!").
8/20/2019 Prosedur Diagnostik neuroooo
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KMI @5
ELEKTROMIOGRAFI
EMG 0• EMGP&1&)*$$' %&'$($($' $*(($+()* (( !&'#$' 1&'""**$' &+&*()!$
7$)"1 %$!$ ((.• G$10$)$' $*(($ +()* !$+$1 (( !&0"(
E+&*()1#)$1.
• E+&*()1#)$1 #$10$)$' *-$ %$!$ ((
()$-$( !$' $*(/ !$' 1&10&)*$' #$10$)$'
$0')1$+ &"$ *&+$'$' +&&+ 1() "'(.
8/20/2019 Prosedur Diagnostik neuroooo
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KMI @8
PRINSIP / INTERPRETASI
EMG
P)'% 1&10&!$*$' +& :
• S$)$/ M() '&")'.
A*'.• S$10"'#$' $)$/ ((.
• O((.
H$+ '(&)%)&($ (!$* 1&10&)*$' !$#'$
*+' %&/*, (&($% 1&10$'(" 1&'$**$'
!$#'$, 0&)$1$ %&1&)*$$' *+', !++.
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KMI @<
INDIKASI EMG
• M() '&")' !&$&.
• G$'# $)$/ (&% $*' 9N&")%$(;.
• G$'# %$!$ '&")1"*"+$) = 7"'('
9M$(&'$ #)$;.
• P&'$*( (( %)1&) 9DMP;.
• M&10$'(" 1&'$**$' !$#' &%&)(B&++ P$+.
• DLL.
8/20/2019 Prosedur Diagnostik neuroooo
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KMI @
N$r2$ C!()%i! S%(i$"
• M!%!r $r2$ )!()%i! "%(i$" 1&'$($(
)&%' &+&*) !$) %$!$ (( (&)-$!$% (1"+$
$)$/ 1()*'$ %$!$ 2 $($" +&0-, &-'##$
!$%$( !(&'("*$' *&&%$($' %&'#-$'($)$'
&)$0"( 1()* %! 2 (&1%$( (1"+$ 9MCV;.
• S$"!r* $r2$ )!()%i! "%(i$"
1&'#"*") *&&%$($' -$'($)$' $)$/ !$'
$1%+("! $(' %(&'$+ %$!$ &)$0"(
&')* 9 KHS ;.