Epilepsy and incontinence

Epilepsy is a long-term neurological (brain) condition characterised by spontaneous, recurrent seizures. It’s the fourth most common brain disorder after migraine, stroke and Alzheimer’s Disease. and affects around 3% of Australians., Epileptic seizures occur due to a disruption to electrical activity in the brain.

This causes a change in person’s movement, behaviour, level of awareness and/or feelings. There are many types of seizures that present in different ways and people with epilepsy experience seizures differently.

Can epileptic seizures cause urinary incontinence?

Yes. Studies show that approximately 39% of people with epilepsy have at least one urinary symptom. Seizures are caused by abnormal electrical impulses in the brain and often happen without any warning signs. This disruption to the brain’s electrical activity can affect your ability to remain continent.

How can incontinence impact people with epilepsy?

Different types of seizures cause incontinence in different ways. For example, Tonic-Clonic (aka Grand Mal) seizures typically involve muscle rigidity, shallow breathing and jerking movements followed by a period of unconsciousness. These seizures cause pelvic muscles to tense, putting the bladder under stress. During this time, it’s common for people to lose control of their bladders.

Atonic seizures induce muscle relaxation which can cause the bladder muscles to relax, allowing urine to flow.Absence seizures affect incontinence a little differently. During these the signals to the brain to retain urine may get mixed up which can lead to a total loss of control.

Other incontinence symptoms related to epilepsy include:

• feeling a strong, sudden urge to urinate (also known as urge incontinence) but not being able to get to the toilet in time

• being unable to fully empty the bladder which results in urine leakage and frequent urination

• being unable to get to the bathroom in time due to physical or mental impairment.

What other neurological disorders cause incontinence?

Epilepsy isn’t the only medical condition that can cause incontinence. Any neurological condition that interferes with the brain’s ability to send messages to the bladder can involve incontinence issues. These include stroke, Parkinson’s disease, multiple sclerosis, a brain tumor or a spinal injury.

How to manage epilepsy-related incontinence

It is possible to manage epilepsy-related incontinence. One of the keys is to prevent seizures where possible. This means:

• ensuring you consistently take your medications

• talking to your pharmacist or doctor before taking any other medication in addition to your seizure medication

avoiding things that trigger seizures such as:

• • alcohol
  • illicit drugs
  • physical and emotional stress
  • flashing lights
  • missing meals

• getting enough sleep.

As it may not always be possible to prevent a seizure, using incontinence products can provide you with peace of mind. If you’re out and about, products such as continence pads or specially designed continence underwear can help you feel more confident, and lessen the impact that a seizure may have.

How can you support those with epilepsy-related incontinence?

Caring for someone with epilepsy can be hard, particularly if they experience incontinence as part of their condition. Things that you can do to support them include:

• ensuring they continue taking their medication in order to limit or control seizures

• help them reduce or avoid things that trigger seizures

practice seizure first aid which involves:

• • keeping other people out of the way
  • clearing hard or sharp objects out of the way
  • not restricting their movements
  • placing them on their side to keep their airway clear
  • timing the seizure
  • calling for help or first aid if required

• carrying extra incontinence products or clothing in case they become incontinent as a result of a seizure

• assist them in cleaning up if they lose control of their bladder

• explaining to family and friends what happens during a seizure including the possibility that they may be incontinent, so they are able to support the person with epilepsy

• be patient and remember the person with epilepsy can’t control what happens during a seizure

• seek the support of specialised continence health practitioners who can advise you on the right continence products.