postseizure

Postseizure, or the postictal state, is the period after a seizure during which the brain gradually returns to its baseline function. The experience varies widely between individuals and seizure types.

Typical symptoms include confusion or disorientation, drowsiness, slurred speech, memory gaps about the event, headaches, and fatigue. Some people may have temporary weakness on one side (Todd’s paralysis), dizziness, sensory changes, nausea, or emotional changes. The duration ranges from seconds to several hours, with most people regaining normal function within a few minutes to an hour after a generalized seizure; confusion can persist longer in some cases.

Causes and mechanisms are not fully understood. Common contributing factors during the postictal period may include transient metabolic disturbances, subtle metabolic or oxygen changes, neuronal exhaustion, and altered blood flow in the brain. The brain gradually restores normal electrical activity as these processes normalize.

Management and safety emphasize protection, airway, and observation. Place the person on their side to reduce the risk of aspiration, ensure the airway is clear, and monitor breathing. Do not offer food or drink until fully awake. If a rescue medication has been prescribed for prolonged seizures, administer as directed. Seek urgent medical care if a seizure lasts more than five minutes, if another seizure follows without full recovery, if there is head injury, trouble breathing, chest pain, or the person does not return to baseline within an expected time.

Postseizure evaluation may occur in medical settings, especially after unusual, prolonged, or recurrent seizures, to assess triggers, medication effectiveness, and any potential complications.