Can UTIs Cause Seizures in Adults? Links, Causes and Treatment

Can UTIs Cause Seizures in Adults?

Urinary tract infections (UTIs) are common bacterial infections that can affect the bladder, kidneys, ureters, and urethra. While UTIs typically cause uncomfortable urinary symptoms, some research suggests they may also be associated with neurological complications like seizures in rare cases.

This article examines the link between UTIs and seizures, the proposed mechanisms, risk factors, severity, diagnostic challenges, and treatment options for adults.

Association Between UTIs and Seizures

Several studies have found a potential link between UTIs and seizure activity:

• A 2020 case report described an elderly woman with no prior seizure history who experienced a generalized tonic-clonic seizure during a severe kidney infection (pyelonephritis). Her seizure resolved after antibiotic treatment for the UTI.
• A retrospective study in Taiwan found that about 3% of adults visiting the emergency room for a first-time seizure had a UTI. UTIs were more common in these patients compared to the general population.
• Researchers examined over 18,000 emergency room records and found seizure patients were more likely to have an abnormal urinalysis indicating possible UTI compared to non-seizure patients.

However, larger controlled studies are still needed to confirm this association and establish how common UTIs are as a cause of seizures in adults.

Proposed Mechanisms for UTI-Induced Seizures

Researchers theorize a few reasons why UTIs may sometimes trigger seizure activity:

Systemic Infection

If a UTI spreads to the kidneys (pyelonephritis) and turns into a systemic bloodstream infection, the bacteria and toxins in the blood could potentially affect the brain and cause neurologic dysfunction.

Electrolyte Imbalances

Kidney infections and dehydration from UTIs can alter electrolyte balances in the body. Rapid shifts in sodium, calcium, magnesium and glucose levels may lower the seizure threshold.

Toxins

Some UTI-causing bacteria like E. coli release toxins that may cross the blood-brain barrier, especially if the infection spreads to the kidneys and urosepsis occurs.

Fever

The high fevers often associated with kidney infections can themselves trigger seizure activity.

Risk Factors for Seizures in UTI Patients

Certain conditions may increase an adult's risk of having a seizure related to a UTI:

• Kidney infection - More likely with systemic effects than simple bladder infection.
• Impaired kidney function - May impact electrolyte regulation.
• History of seizures - Lower seizure threshold.
• Electrolyte disorders - Upsets electrolyte balance.
• Dehydration - Due to fever, vomiting, poor fluid intake.
• Advanced age - Weaker immune system, impaired organ function.
• Diabetes - Higher UTI risk, fluctuating blood glucose.
• Immunocompromised state - Reduced ability to fight infection.

Seizure Types Associated with UTIs

The seizure pattern seen with UTIs can vary:

Generalized Seizures

Research indicates generalized tonic-clonic seizures are most common. These involve loss of consciousness and muscle stiffening followed by jerking. However, absence seizures (staring spells) and myoclonic seizures (muscle jerks) have also been reported.

Focal Seizures

Some cases involve focal seizures where convulsions start in one area of the brain. This can sometimes progress to a bilateral tonic-clonic seizure. Focal seizures may cause dizziness, tingling, nausea, confusion, or speech and visual disturbances.

Febrile Seizures

The high fevers of kidney infections can trigger febrile seizures, especially in those with a childhood history of fever-related seizures.

Breakthrough Seizures

Those with an existing seizure disorder may experience breakthrough seizures due to the stress of infection and electrolyte imbalance.

Severity of UTI-Related Seizures

The characteristics and severity of seizures associated with UTIs can vary between patients:

• Single seizure or recurrent seizure clusters
• Brief seizures less than 2 minutes or longer lasting status epilepticus
• Consciousness impaired or maintained
• Spontaneous resolution or need for anti-seizure medication
• Quick return to baseline or lingering post-seizure symptoms

Seizures due to UTIs tend to be milder and more transient in otherwise healthy adults but can be more severe and difficult to control in those with underlying neurological or metabolic conditions.

Diagnosing UTI-Related Seizures

It can sometimes be challenging for doctors to determine if a seizure was caused by a UTI. Considerations include:

• No past history or family history of seizures
• Recent UTI diagnosis and antibiotic treatment
• Concurrent UTI symptoms like dysuria, frequency, fever
• Urinalysis shows bacteriuria, leukocytes, nitrites
• Urine culture identifies pathogenic bacteria
• Signs of kidney infection on imaging like CT scan
• Exclude other potential seizure triggers like medication changes, head trauma, illicit drug use, electrolyte disturbance

Isolating the UTI by treating it with antibiotics and seeing if seizures also resolve can help confirm the relationship in ambiguous cases.

Treating Seizures Caused by UTIs

Treatment involves both addressing the UTI itself and managing any resultant seizures:

Antibiotics

Prescribing appropriate antibiotics to eradicate the UTI is the primary treatment. This will help resolve any associated fever, dehydration, and neurological symptoms.

IV Fluids

Fluid resuscitation with intravenous isotonic fluids may be used to reverse dehydration and electrolyte disturbances.

Medications for Fever

Antipyretic medications like acetaminophen or ibuprofen can help reduce high fevers associated with kidney infections.

Anti-Seizure Medications

Some patients require short-term anti-epileptic drugs to control UTI-related seizures and prevent status epilepticus. These are typically continued until the infection has resolved.

Admission for Monitoring

Hospital admission may be warranted in severe cases for monitoring and to allow rapid intervention for further seizures or worsening infection.

Preventing UTI-Related Seizures

It is difficult to completely prevent seizures caused by UTIs. However, the following measures can help lower risk:

• Practice good hygiene and urinate after intercourse to reduce UTIs
• Stay well hydrated and urinate frequently
• Treat all UTIs quickly to avoid progression to kidney infection
• Carefully monitor diabetics with frequent urinalysis for asymptomatic UTIs
• Control urinary incontinence to avoid bacteria entering the urinary tract
• Have any structural urinary tract abnormalities like stones or blockages repaired

Prompt evaluation of UTI symptoms and early treatment with antibiotics are key to preventing systemic complications like seizures.

Prognosis of UTI-Induced Seizures

The prognosis for seizures related to UTIs is often good, especially for individuals without pre-existing neurological conditions. Some key points about outlook include:

• Seizures are expected to resolve once the UTI has been effectively treated.
• Recurrence risk is low unless the person develops frequent UTIs or has an underlying seizure disorder.
• No anti-seizure medication is typically needed long-term after the UTI has resolved.
• Neurological function usually returns to baseline without permanent deficits.
• In rare cases, prolonged seizures can cause brain injury and lasting neurological consequences.

Rapid UTI treatment is key to optimizing prognosis and minimizing any temporary or permanent effects of seizure activity.

Warning Signs to Seek Urgent Care

Adults should seek prompt medical attention for the following signs that may indicate a UTI-related seizure:

• First-time seizure in the setting of UTI symptoms
• Uncontrolled seizure activity lasting more than 5 minutes
• Recurring seizure without regaining consciousness
• Marked confusion, difficulty awakening, or other impaired mental status after a seizure
• Head injury from a seizure causing loss of consciousness
• Difficulty breathing or turning blue after a seizure
• New weakness or inability to move part of the body after a seizure

Rapid medical intervention is crucial for diagnosing and treating the underlying UTI to stop any potentially life-threatening seizure activity and prevent neurological damage.

Key Takeaways

Although uncommon, UTIs may sometimes trigger seizure activity in adults likely due to systemic effects of infections, electrolyte imbalance, fever, and bacterial toxins. Seizures most often resolve once appropriate antibiotics treat the underlying UTI. However, UTIs causing repeated seizures, prolonged seizures, or other concerning symptoms warrant prompt medical care to avoid the risk of permanent neurological injury. Increased awareness of the link between UTIs and seizures can improve diagnosis and outcomes.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.