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What is a Postictal State?

The postictal state often occurs after an elliptical seizure. During this period, the individual possesses a disturbed consciousness state, making it for him or her to understand the surroundings completely. In simple words, the individual finds himself/herself in a confusing state and the postictal state lasts anywhere between 5 and 30 minutes. However, there are certain cases where an individual can experience the state for a more extended period.

What is a Postictal State?

What is a Postictal State?

According to Jerome Engel, the postictal state produces alteration to the neuronal function but not to the entire structure. After a seizure effect, it is common that the individual experiences exhaustion, both mentally and physically. The fatigue can remain for a maximum time of two days. Mostly, patients often complained about the confused state, inability to think appropriately, short-term memory loss, reduced concentration levels, decreased interactive skills, and other cognitive defects that alter from one individual to another. The collection of all these cognitive defects defines the postictal state.

Signs and Symptoms of Postictal State

  1. Postictal Migraines

    Majority of the patients who have epilepsy complain about a symptom of postictal migraines in postictal state. A significant notice that neurologists often view among their patients is the variation in the etiologies. The major possibility for the occurrence of migraines is the intracranial pressure that occurs due to postictal cerebral edema. Sometimes, the migraine will be the only clue for the doctor to conclude that the patient had a seizure attack. Depression is another symptom found in many of the patients who had postictal migraines.

  2. Todd’s Paresis

    Defining Todd’s Paresis is simple because it is only a regional loss that occurs only in any one of the regions where the attack took place. The demonstration of this symptom of postictal state depends on the location of the seizure. The major factor that can cause a severe trouble, in this case, is the occurrence of motor function, that can lead an individual feeling from weak to fall prey to full paralysis. Patients with tonic-clonic seizures displayed motor function disability along with temporary loss of hearing, sight, and numbness.

  3. Postictal Psychosis

    Although postictal psychosis occurs as a rare symptom of postictal state, patients experience auditory, visual hallucinations, paranoia, aggression, and delusions. After the conclusion of the seizure attack, the individual remains confused for a few seconds experiencing the symptoms, and then gradually regains consciousness and returns to the normal state. The period, known as lucid phase, can last for two hours or more than a week. About 20 to 50% of the patients suffering from the seizure attack display the psychosis phase which can last from 12 hours to over three months. The stage is curable using antipsychotic drugs, and the doctor can reduce the dose and stop the medication when the individual shows no signs of seizures.

  4. Postictal Bliss

    Patients also complain about postictal bliss symptom of postictal state after a seizure attack. The occurrence of postictal bliss is due to the appearance of amnesia. It is common for the individual who underwent the attack to experience the symptoms for a few hours, a day or two. In several cases, unresponsiveness and confusion are the common symptoms. It can act as a signal for the clinicians that the individual never had a seizure if there are no signs of these after an attack. In such cases, clinicians often relate the situation to the psychogenic origin.

It is quite helpful for a clinician or neurologist in determining the origin of the seizure with the help of the postictal state. For example, short-term memory loss occurs due to seizure in the dominant hemisphere whereas visual memory loss occurs due to seizure attack and non-dominant hemisphere.


  1. “Postictal State: Symptoms, Duration, and Treatment” – Verywell Health. https://www.verywellhealth.com/what-is-the-postictal-state-4174819

  2. “Postictal State” – Epilepsy Foundation. https://www.epilepsy.com/learn/seizure-and-epilepsy-101/what-happens-during-seizure/postictal-state

  3. “Postictal States” – Medscape. https://emedicine.medscape.com/article/1187184-overview

  4. “Postictal Confusional State (PCS)” – MedLink Neurology. https://www.medlink.com/article/postictal_confusional_state_pcs

  5. “Postictal State: Understanding the Aftermath of Seizures” – Healthline. https://www.healthline.com/health/epilepsy/postictal-state

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:December 1, 2023

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