What Is Post Seizure Paralysis?

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What is Postictal Paralysis?

Sometimes, a person can experience weakness after having a seizure. This neurological condition is characterized by a brief period of temporary weakness that begins following a seizure.

Post seizure paralysis can be either partial or complete and usually affects a specific part of the body. The paralysis typically lasts from one hour to thirty-six hours. While it can occur with any form of seizure, post seizure paralysis usually affects people who have epilepsy, which is a condition characterized by a tendency to have recurrent seizures.

What Does Postictal Mean?

A seizure is generally characterized by decreased level of awareness, staring, or uncontrolled movements or twisting of the face, arms, legs or body. After the obvious signs of a seizure are over, some people do not recover immediately and continue to experience what is described as a postictal state.

The postictal phase of recovery is not an actual seizure, although a seizure can result in temporary neurological changes that are typical during the postical state, such as fatigue, extreme sleepiness, staring, headaches, confusion and changes in behavior.

Post seizure weakness is one of the less frequent symptoms that can occur during the postictal state. Post seizure weakness may be called postictal paralysis, Todd’s paresis, Todd’s paralysis, or Todd’s palsy.

Recognizing Postictal Paralysis

The symptoms of postictal paralysis include loss of function or decreased function of one or more parts of the body.

The most common symptoms include:

  • Mild or severe weakness
  • Complete paralysis of an arm or leg or one side of the body
  • Changes in vision
  • Numbness
  • Blindness
  • Loss of bowel or bladder control
  • Confusion, drowsiness and lack of responsiveness are often present during postictal paralysis

Often, if an arm or leg  was shaking during a seizure, that is the arm or leg most likely to become weak during the postictal state, although this is not necessarily always the case.

Symptoms of postictal paralysis usually resolve within minutes to hours after they begin. The symptoms may gradually improve or they may suddenly resolve.

Diagnosis Of Postictal Paralysis

If you or a loved one has symptoms of postictal paralysis, it is not easy to know whether you truly have postictal paralysis, or whether you have another neurological condition, such as a stroke. There are many similarities between seizures and strokes, and this can be very confusing for you.

However, it is important to know the difference between a seizure, postictal  paralysis and a stroke, because the treatment for these conditions is different, and it is vital for you to receive the right treatment for your long term health. There are a number of medical tests that can confirm the diagnosis of postictal paralysis. Some of these tests include:

Treatment and Prevention Of Postictal Paralysis

The best way to prevent postictal paralysis is by preventing seizures from happening. Seizures can be prevented with anti epilepsy medications. There is no specific medical treatment for postictal paralysis aside from preventing the seizures themselves. With rest, postictal paralysis will eventually disappear within minutes to hours.

The good news is that postictal paralysis is not harmful. It does not cause long term weakness or recurrent seizures. For some people with epilepsy, postictal paralysis is a part of the recovery stage.

What Are the Causes Postictal Paralysis?

Overall, the actual cause of postictal paralysis is not perfectly understood.

There is some evidence suggesting that a decrease in blood flow to specific regions in the brain after a seizure affects the function of neurons in the brain, producing symptoms of postictal paralysis. Some studies suggest that the electrical activity itself, which is disrupted during a seizure, takes time to resume normal activity and function.

A Word From Verywell

If you experience sudden weakness, it is important to get medical attention right away, as this can be an emergency requiring urgent medical treatment. If you have been diagnosed with postictal paralysis, you and those who you spend time with should learn to recognize your signs and symptoms, so that you can  safely get to rest while you recover from your seizure.

Living with epilepsy requires an understanding of your symptoms so that you can be aware of what to expect and how to stay seizure free, as well as how to stay safe if you do experience a seizure.

Sources:

Definition of the postictal state: when does it start and end? Fisher RS, Engel JJ Jr. Epilepsy Behav. 2010 Oct;19(2):100-4

Postictal Todd's Paralysis Associated with Focal Cerebral Hypoperfusion on Magnetic Resonance Perfusion Studies, Yacoub HA, Fenstermacher N, Castaldo J, J Vasc Interv Neurol. 2015 May;8(2):32-4

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