Secondary enuresis: Post-traumatic stress disorder in children after car accidents

Background: In our experience, secondary enuresis. nocturna is a common complaint among children after a motor vehicle accident. However, as these children are often brought; for examination as part of an insurance compensation claim, this complaint is not always reliable. Objective: To describe a series of children in whom secondary enuresis occurred after a motor vehicle accident. Methods and Results: Five children were brought to our clinic for evaluation of secondary nocturnal enuresis. Review of past history revealed a car accident preceding the onset of the enuresis. All but one had additional behavioral symptoms typical of post-traumatic stress disorder. Four children had evidence of head trauma, and one had psychological but no physical trauma. Conclusions: Nocturnal enuresis can occur after a motor vehicle accident due either to purely psychological trauma or organic head trauma. While nocturnal enuresis is generally attributed to organic causes, psychological mechanisms also play a significant role.