Question - incontinence and pacemaker

[Leea9]

Hi,

I have asked about Tim before and you were very helpful. His sister is full time care taker. First brief history.

He has had seizures for years. He is heavily medicated and they are under control to once a month to every couple of months. He is intellectually challenged and if you ask him how he is he always says fine. If you ask him what is wrong he can't put it into words. If you ask does your stomach hurt he can say yes or no. A seizure has been just loss of consciousness and fall to the floor, lasts less than a minute and then slow return to normal.

A week ago just before a return flight he had a seizure in the airport. Traveling will do that to him. It had been a couple of months. She got a wheelchair just to make it easier to move. He had 2 more during a lay over. That third one scared his sister. It lasted longer and he lost urinary continence. That had happened only once before about 6 months ago and that seemed to be a minor seizure, and no incontinence since till now. They would not let him on the airplane and sent him to the hospital. In the emergency room he had a fourth seizure and cardiac arrest. We are lucky that happened in an emergency room. They moved him to ICU and he arrested 3 more times that night. They put in a pacemaker the next day.

He was on 5 anti seizure drugs, they stopped the Vimpat thinking it may have lead to the cardiac arrest so he now has 4. I can't find the effect of stopping Vimpat cold turkey but it can't be good. The hospital messed up his other dosages but that is another story.

Finally my question. How common is incontinence during a seizure? Should it have been treated as a precursor to worse problems.

thanks
Lee

 

[masterjen]

Incontinence definitely does happen during seizures; it's not unusual but I can't honestly say just how common. It is more likely to happen during a tonic-clonic seizure, but can also happen during a complex partial, atonic or tonic seizure. Occasional incontinence during a tonic-clonic might simply be related to how full the bladder is at the time, but if it is happening frequently when before it was never or almost never then letting his neurologist know about this change is important. Just my opinion.

For your own comfort, a quick phone call to his neurologist is never harmful if it makes you feel better. Peace of mind is important

 

[Howll]

I'm not sure that it's a precursor to anything else. I've had incontinence 3 out of 4 of my tonic clonics, it's a natural response in seizures as far as I'm aware and quite common.

 

[Nakamova]

How common is incontinence during a seizure?

I did a search, and it looks like there haven't been any substantial studies about this. It may be tough to gather the data since in many cases it involves self-reporting, and folks may not always want to report incontinence, or remember experiencing it.

That said, I agree with masterjen that severity of the seizure plus bladder fullness are probably the most relevant factors. (Though perhaps his being in a wheelchair may also have been a factor, since it can be more difficult to get to restroom? Just a guess.) I peed myself during the very first tonic-clonic seizures I ever had (one followed soon after by a second one in the ER), which were fairly dramatic. Since then, it's never happened again.

Five anti-seizure meds is a lot -- it can make it harder to gauge side effects/efficacy and easier to confuse doses or miss one altogether, and the meds may interact with each other. So it's not necessarily add a bad idea to take one out of the mix. Stopping cold turkey can be problematic, but since Vimpat has a known risk for cardiac side effects, and since Tim was still on other anti-seizure meds, the hospital docs probably felt that stopping the Vimpat was the best choice to protect his heart.

It would be a good idea to let his neuro know about the increase in seizures and the heart problems, with an eye to re-evaluating and possibly adjusting his meds.

 

[Cint]

Finally my question. How common is incontinence during a seizure? Should it have been treated as a precursor to worse problems.

Hi Lee,

Sorry to hear about Tim's ordeal. I've suffered from E for years, CP seizures and TCs as well. I also traveled overseas as I was married to a pilot and got the "perks" to traveling back then. I've only one time had a CP at an airport, so I could continue my flight. However, I've had a few when I returned from my trip, probably from the exhaustion. Several times, I've had a TC and suffered from incontinence during the seizure. But it's only happened to me during the TCs. And I've had many TC seizures, too. Sometimes it happens........

 

[Leea9]

Thanks for the help.

Oh yeah, she let the neurologist know about the incontinence and other things. He didn't do anything. She wants to change to a new neurologist.

He manages his meds very well. OCD is a side effect of something he takes and he is VERY OCD about his meds on time. He takes them 7 times a day. The seizures seem to be time and medication dependent.

 

[Jezy]

My seizures are usually nocturnal and during a tonic or grand mal seizure it is fairly common to be incontinent the longer thə seizure the more likely.