A seizure is a sudden, temporary disruption of brain activity resulting from abnormal electrical signals. This can lead to a variety of involuntary physical symptoms.
Why Involuntary Urination Occurs During Seizures
Involuntary urination, medically known as urinary incontinence, is a common occurrence during certain seizure types. This happens because the brain temporarily loses its normal control over muscle function. During the intense muscle contractions of a seizure, particularly the tonic-clonic phases, the bladder muscles can contract forcefully, while the urinary sphincter muscles, which normally keep urine in, may relax.
The disruption of signals from the brain to the bladder and pelvic floor muscles can lead to a complete loss of bladder control. It is a purely involuntary physiological response to the widespread electrical activity in the brain. This occurrence is not a sign of shame or a lack of personal control, but rather a direct symptom of the seizure itself.
The increased intra-abdominal pressure from the jerking movements during a tonic-clonic seizure can also contribute to involuntary urination.
Other Physical Changes During a Seizure
Beyond urinary incontinence, other involuntary physical changes can occur during a seizure. Some individuals may experience a loss of bowel control, also known as fecal incontinence. This, like bladder control loss, is due to the brain’s uncontrolled electrical activity affecting the muscles responsible for bowel function.
Other common manifestations include tongue biting, which can happen if the jaw muscles clench forcefully. Frothing at the mouth may occur from saliva mixing with air during altered breathing patterns. Groaning or making other sounds can result from air being forced past stiffened vocal cords.
Temporary cessation of breathing, or apnea, can also be observed as the brain’s respiratory control centers are affected.
Seizure Types and Involuntary Actions
Involuntary urination and other significant physical changes are most often linked with generalized tonic-clonic seizures. These seizures involve abnormal electrical activity across the entire brain. During the “tonic” phase, muscles stiffen, followed by the “clonic” phase of rhythmic jerking.
Other seizure types do not involve these physical manifestations or loss of bladder control. For instance, focal aware seizures, which originate in one part of the brain, generally do not cause a loss of consciousness or widespread muscle involvement. Absence seizures, characterized by brief staring spells, also typically do not result in incontinence or convulsive movements, though they can cause a temporary loss of awareness that may disrupt bladder signals.
How to Help Someone Having a Seizure
If you witness someone having a seizure, remaining calm is the first step. Begin by timing the seizure, as this information is helpful for medical professionals. If the seizure lasts longer than five minutes, or if it is the person’s first seizure, call emergency services.
Protect the individual from injury by clearing the area of any hard or sharp objects. Cushion their head with something soft, like a jacket or pillow, to prevent head trauma. Loosen any tight clothing around their neck, such as a tie or collar, to aid breathing.
Once the convulsive movements stop, gently roll the person onto their side into the recovery position. This helps keep their airway clear and prevents them from choking on saliva or vomit. Stay with them until they regain full awareness and offer reassurance as they recover, as they may be confused or disoriented.
Avoid restraining the person or attempting to stop their movements, as this can cause injury. Do not place anything in their mouth, including your fingers, as this can lead to dental or jaw injuries; people cannot swallow their tongue during a seizure. Do not offer food or drink until they are fully awake and alert.