Postictal state

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

The postictal state is the altered state of consciousness that a person enters after experiencing an epileptic seizure, such as those occurring with frontal lobe epilepsy. It usually lasts between 5 and 30 minutes, but sometimes longer in the case of larger or more severe seizures and is characterized by drowsiness, confusion, nausea, hypertension, headache or migraine and other disorienting symptoms. Additionally, emergence from this period is often accompanied by amnesia or other memory defects. It is during this period that the brain recovers from the trauma of the seizure.

While the post-ictal period is considered to be the period shortly after a seizure where the brain is still recovering from the seizure, the ictal period is considered to be the seizure itself, and the interictal period to be the period between seizures, when brain activity is normal.

The duration of the postictal state and the symptoms experienced in the postictal state vary from person to person and are also heavily dependant on the type of seizure experienced. There is no noticeable postictal period for atonic seizures or absence seizures, and sufferers can get back to their normal life immediately after a seizure.

Other forms of seizure will have a varying postictal state, depending on which part of the brain was affected and how severe the seizure was. A person who has just had a tonic-clonic seizure will invariably be deeply asleep for 5-30 minutes following the seizure, after which they may wake to find themselves confused and drowsy, often accompanied by a headache or migraine. In some, this passes after only a few minutes. In others, these symptoms may remain for several hours or the rest of the day. Some will return to sleep as soon as they can.

Focal seizures such as simple partial seizures will often have a short postictal period, lasting only a few minutes. This is usually manifested by confusion and drowsiness and with complex-partial seizures. Some people will also fall unconscious as with a tonic-clonic seizure.

• Epilepsy & Seizures on NeurologyChannel