Postictal Manifestations

Postictal manifestations generally correspond to the severity of symptoms during seizures and include confusion, focal weakness, and headaches. Postictal weakness (Todd's paralysis) is usually brief and follows severe or prolonged ictal motor activation. Postictal amnesia and transient aphasia are common when seizures involve memory and dominant hemisphere language areas, usually in temporal lobes. Postictal psychosis may emerge from a postictal delirium or following a latent period. It is important to distinguish prolonged postictal delirium from continuing nonconvulsive seizures. Electroencephalogram (EEG) and magnetic resonance imaging (MRI) changes generally correspond to postictal manifestations with slowing and transient signal increases.