Postictal State: Definition, Seizure Phases and Symptoms of this Seizure Condition

Experiencing a seizure can be a terrifying ordeal.

One of the most perplexing parts of a seizure that you can experience happens right after the seizure ends.

Known as the postictal phase of a seizure, this is the stage when a person’s body begins to recover from the seizure. It occurs between the end of its seizure and its return to its reference condition.

Recovery time during this period may vary. Some patients can recover from their attack immediately, while others can take anywhere from a few minutes to a few hours.

As a result of a seizure, a person can experience injuries ranging from head trauma and bruising to bone fractures and bitten tongues.

There may also be an emotional component characterized by feelings of shame, anxiety, frustration, or sadness.

Posttictal migraines are a common complaint among people with epilepsy. One possible explanation for this is cerebral edema ( swelling of the brain ) that can result from a seizure, causing increased intracranial pressure and pain.


Sometimes, a person may only be aware of a seizure when a typical migraine appears.

On the other hand, it is known that postictal happiness, described as having a comfortable feeling, occurs after a seizure.

Phases of seizures

Commonly, there are three stages of seizures, and they are known as follows:

  • The aura
  • The stroke.
  • The postictal state.

In the aura stage, a person begins to notice changes in their smell, taste, sight, hearing, and emotional state. The second stage, known as the stroke stage, is where the person experiences the seizure, which can vary depending on the type of seizure and the region of the brain affected.

The third stage that follows the stroke is the postictal stage. Moreover, it occurs during the person’s recovery from the seizure.

Symptoms of the postictal state

The symptoms that a person suffering from a seizure can expect during the postictal phase can vary widely due to the various types of epileptic seizures and the parts of the brain that impact their seizure.

However, the postictal phase generally affects the patient’s cognition and consciousness, showing signs of mental and physical impairment.

When the body experiences a seizure, different body systems can be affected.

Mental symptoms

  • Difficulty or inability to answer questions.
  • Drowsiness/drowsiness
  • Confusion.
  • Memory loss.
  • Difficulty or inability to speak or write.
  • Dizziness/lightheadedness
  • Depression/sadness.
  • Feeling scared or anxious
  • Frustration / embarrassment.

Physical symptoms

  • Injuries from the seizure, such as bruises, cuts, head trauma, or broken bones.
  • Headaches or migraines.
  • Nausea / upset stomach.
  • Dehydration.
  • Feeling weak/fainting.
  • The sudden need to use the bathroom/loss of bowel or bladder control.

While the underlying causes of the postictal phase of a seizure are still unknown, the stage is associated with different levels of cognition, and physical decline as the body begins to recover from the seizure.

Lasting from a few minutes to several hours, people emerging from an attack should pay attention to their changes in behavior / physical and mental decline before returning to their normal activities.


The postictal state is the abnormal condition between the end of an epileptic seizure and the return to the baseline condition.

Operational application of this definition can be difficult, especially for complex partial seizures, where cognitive and sensorimotor deficits are imperceptibly combined in the postictal state. Many patients are unaware that they have even had a seizure.

Electroencephalography can sometimes help distinguish ictal from postictal periods, but it can show a decrease in concentration both during and after a seizure.

Epileptiform EEG changes do not always correspond to behavioral changes, especially in scalp recordings.

The postictal state ends in the interictal state, but this can also be ambiguous. Interictal spikes and wave spikes may be associated with cognitive and behavioral deficits, suggesting that they may represent fragments of ictal episodes.

Except where the boundaries are clear, it is best to describe a sequence of EEG behaviors and changes without labeling arbitrary stages as ictal or postictal.