What is a postictal state?

Jerome Engel, MD
An epileptic seizure is caused by excessive activity of nerve cells in the brain. Often, when the seizure is over these cells are exhausted and require time to recover. An epileptic seizure is also called an ictus so the postictal state refers to any dysfunction that occurs after a seizure while the brain is recovering from the ictus. For generalized tonic-clonic seizures, where the entire brain is eventually involved, the postictal state can consist of complete unresponsiveness with gradual recovery associated with confusion and other symptoms that can take hours, while brief absences have no postictal symptoms at all. Dysfunction can occur after focal seizures, and the feature of the postictal symptoms depend on the area of the brain involved in the seizure. Most commonly, focal motor seizures, for instance involving clonic movements of one hand and arm, can be followed by weakness of the same hand and arm for minutes or sometimes a day or more. Postictal visual deficits and memory problems also often occur. The types of postictal symptoms experienced by patients with epilepsy are as varied as the seizures themselves and, for some patients, disability may be caused more by the postictal symptoms than by the seizures.
Postictal state is defined as behavioral changes after a tonic-clonic seizure. It may consist of agitation, confusion, aggressive behavior or unresponsiveness and may last for up to 24 - 72 hours.

The postictal state is the period following a seizure, which sometimes includes a headache, confusion, soreness or fatigue.

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