status epilecticus question

[ontocrna]

Question: Pt. seizes for many minutes and yet needs to be straight cathed 10 minutes following status epilectic state....750cc out.....shouldn't pt have been incontinent of urine in seizure state of great length? What am I missing? Conscious pt on either side of the lengthy seizure asked to be straight cathed following seize with no remarkable gu hx to explain necessity...pt. just didn't like the bed pan option and I can't figure out how pt. didn't lose the urine while having a valid seizure of substantial length?????

[DahliaDaisy, RN]

Not a nurse, but my husband had an idiopathic seizure disorder which eventually killed him.He would have lengthy tonic clonic seizures bi-weekly but only became incontinent once. So, it can and does happen. Folks are all different I guess.

[emily5547]

As the previous poster mentioned, not everyone becomes incontinent after a seizure, but when they do, it's AFTER the seizure, when the muscles relax finally. So, in status, I guess it would make sense that the pt wouldn't void. I never thought about this... I am a dialysis nurse but have a seizure disorder myself... Surely someone with more nursing experience in neurology will chime in.

[bellehill, RN]

After having a lengthy seizure I am surprised the patient was alert enough to ask for a straight cath. Depends on what type of seizure they had and how long, everyone is different. If they had a tonic-clonic seizure for more than 5 minutes they shouldn't have been conscious enough to ask to be straight cathed after the seizure. Just my experience with seizure patients.

[vashtee, RN]

Not all sections of the brain are necessarily affected by a seizure. This is why there is such a wide variety of types of seizures.

My daughter has lots of seizures (including tonic-clonic) that have lasted up to 4 minutes, and has never (yet) been incontinent, which is good because she is only a teenager, and finds the whole ordeal humiliating enough as is.