Natural Enuresis Treatment
99 Ways To Stop Bedwetting
53 Minutes From Now, You'll Know Exactly How To Stop Your Child From Wetting The Bed...Without Drama Or Discipline. It's one of the hardest problems families face and can be very tough on a child's self esteem. When one of your children is a bed wetter, it can be a very sensitive topic. Even though it's a normal part of growing up, siblings can still give them a hard time.
Interictal electroencephalograms (EEGs) were normal except for a mild slowing in the left frontocentral region. Five seizures were recorded during video-telemetry. Seizures were all induced by an unexpected acoustic stimulus (Figure 25.2). The seizures started with a startle reaction, followed by tonic posturing with symmetrical extension of arms and legs, accompanied by a loud, undulating, high-pitched vocalization. This was followed by rhythmic pelvic movements, a rolling of the body and frenetic, thrashing movements of all limbs. There was also enuresis associated with long seizures. There was no postictal confusion the patient was immediately able to act and speak, and he claimed to be aware of everything that happened during the seizure. Seizure duration was always less than 1 min. The duration and severity of seizures were inconstant however, the sequence of motor elements was highly stereotypic. Ictal surface EEGs were unrevealing beyond movement artifacts.
When the mother and the girl were shown the video-EEG, they realized what the problem was and finally became motivated to try a new drug. The girl was started on ethosuximide syrup without any adverse events. The absences disappeared and the child slowly regained her self-confidence. It was possible to get leave for the mother from her job for 2 months so that she could support the child. The daughter was able to regain her confidence about her school performance. The bed wetting disappeared after the valproate was tapered off (it had previously been unsuccessfully treated with a reward of 5 Danish kroner for each dry night and a penalty of 2 Danish kroner for each wet night). At discharge the patient could return to her school without problems, and the EEG was normal.
A 15-year-old boy was admitted for uncontrolled seizures of several types. On video-EEG he was seen to stop his activity (writing) and look thoughtful, then abruptly to push his chair away from the table and look down at his lap in surprise. He called the nurse to say I had a little flash. When asked what he meant he reported that he had had a seizure and wet himself. The origin of this patient's epileptic seizures was widespread areas of the frontal lobe, including some clearly starting in the cingulate gyrus. Isolate enuresis was not recorded on intracranial monitoring (51).
The other parasomnias are disorders in which the phenomena of interest are not closely associated with a particular stage of sleep. Of the other parasomnias, features of three may suggest the possibility of epilepsy sleep bruxism, sleep enuresis, and nocturnal dissociative disorder. In the psychogenic nocturnal dissociative disorder, conscious awareness becomes dissociated from behavior, and patients perform complex activities for which they are amnestic. Patients are often young women with psychiatric conditions, and the episodes are sometimes accompanied by self-mutilating behavior and injuries.
Sleep enuresis, defined as recurrent involuntary bedwetting that occurs beyond the age of expected nocturnal bladder control, is a common distressing disorder. The age at which continence is expected varies across cultures while the prevalence of continence is similar. In general, girls attain nocturnal continence earlier than boys. If continence has never been attained, the disorder is called primary sleep enuresis, while enuresis that recurs following a period of at least 3 months of bladder control is called secondary sleep enuresis. Primary sleep enuresis accounts for 75 of cases however, in older children, up to half have secondary enuresis. Because nocturnal seizures may be accompanied by incontinence, epilepsy is sometimes a part of the differential diagnosis. The majority of children achieve bladder control by age 4 with a 1-3 prevalence of enuresis at age 12 and a 1 prevalence in young adults (Schmitt, 1984 Klackenberg, 1987 Friman and Warzak, 1990). Daytime enuresis occurs...
Genetic factors may play a role in some cases. Enuresis is more common in children of enuretics than in the general population, and in some families, the pattern of involvement is consistent with an autosomal dominant inheritance with greater than 90 penetrance. Linkage to markers on chromosome 13 has been reported (Eiberg et al., 1995). Primary sleep enuresis is caused by a combination of genetic, maturational, psychosocial, and endocrinological factors the relative importance of each of these varies across individuals. Anatomic abnormalities of the genitourinary system and other sleep disorders such as obstructive sleep apnea are uncommon in enuretic children although they may contribute to enuresis in some (Friman, 1995). Psychosocial factors that may contribute to or exacerbate enuresis include marital discord, parental separation, sexual abuse, and birth of a sibling. Maturational factors may also contribute because enuretic children tend to have lower birth weight, delayed...
The parasomnias refer to clinical disorders consisting of undesirable physical phenomena that occur predominantly during sleep (DCSC, 1990). They have been classified based on the stage of sleep from which they originate. They include both normal and abnormal phenomena. Included in the category of NREM parasomnias are hypnic jerks and hypnic imagery, considered to be normal, in addition to confusional arousals, sleep terrors (pavor nocturnus), and sleepwalking (somnambulism), referred to as disorders of arousal. These all originate from deep NREM sleep, stages 3 and 4. They are all common in childhood and decrease in frequency as age increases. These individuals tend to have a family history of similar disorders. REM parasomnias include nightmares and REM behavior disorder (RBD). A third group consists of disorders that may occur during any or all sleep stages and includes bruxism, enuresis, rhythmic movement disorder (including head-banging), sleep talking (somniloquy), and...
Postictal sleep is a common phenomenon after a generalized tonic-clonic seizure. The patient may pass through several stages from sleep to delirium to drowsiness before awakening. During the late postictal state, the heart rate begins to normalize from the typical ictal tachycardia. There is a decrease in muscle tone with bladder sphincter relaxation and incontinence that typically occurs in the early postictal phase. In the immediate postictal phase, there is partial obstruction of the airway resulting in stertorous respirations. Deep tendon reflexes are diminished and the plantar responses are sometimes extensor. The patient then may pass into sleep. If the seizure occurs during the night, the patient may sleep through the postictal period and awaken with complaints of tongue soreness, muscle aches, or nocturnal enuresis. Patients may often experience postictal morning headaches or unexplained bruises.