Post seizure care - planning for the postictal phase of a seizure

  • August 9, 2023
  • 3
     
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In this article
A friend comforting her friend after a seizure

When people think about epileptic seizures, they often think about the symptoms of the seizure itself. But it’s also really important to be aware of experiences, feelings and issues that you might experience afterwards too. 

The time after a seizure has finished, which is known as the postictal phase of a seizure, can be just as impactful on a person with epilepsy’s quality of life as the seizure itself.

Let's learn a bit more about the post ictal phase, before looking at post seizure care, and tips for recovering from a seizure.

What is the postictal phase of the seizure?

The postictal phase is a period of time that begins immediately after the end of an epileptic seizure. It often lasts between five minutes and half an hour, but can last several hours, or even a few days. Post seizure symptoms can vary a lot between people, depending on things like the type of epilepsy they have and their age.

People experience post seizure symptoms because of the changes in electrical patterns and chemical balance caused by the seizure.

Post seizure symptoms and experiences fall into the following categories.

Mainly mental symptoms

Common mental post seizure symptoms include:

  • Memory problems
  • Feeling exhausted
  • Confusion
  • Feeling anxious and afraid
  • Sadness

Mainly physical symptoms

Some of the more common physical post seizure symptoms include:

  • Headaches and migraines
  • Feeling thirsty
  • Feeling sick or having an upset stomach
  • Feeling weak
  • Losing control of your bowels or bladder
  • Sore muscles

Depending on the type of seizure you had, you may also need treatment for injuries such as bruises, cuts, bitten tongue, broken bones, or head injuries.

Psychiatric symptoms

Although they are less common, some people experience psychiatric problems after a seizure. These can last just a few minutes, but can also continue for days or even months:

  • Depression
  • Psychosis (losing touch with reality)
  • Hallucinations
  • Delirium (feeling very confused)

Social problems

People who experience seizures may also feel embarrassed or ashamed. Some may also face stigma at work, school or in their community.

Standing up to stigma: Epilepsy facts vs epilepsy myths

How long does it take to recover from a seizure?

Everyone is different, so there’s no simple answer here. As noted above, the post-ictal phase often lasts between about 5 minutes and 30 minutes. But for some people, recovering from a seizure can take just a few seconds, whereas other people need several hours or days before they feel normal again. 

The kinds of seizures you have also affect recovery time. For example, people who have focal onset aware seizures may be able to continue what they were doing before the seizure instantly. But people who have tonic-clonic seizures could need several hours to recover. Also, if you injure yourself during the seizure, that could also affect recovery time. 

Post seizure care

The most important thing to remember for post seizure management is that everybody's postictal phase is unique to them. Some people with epilepsy find they can ‘bounce back’ quite quickly from a seizure. But other people need longer to recover - this can be frustrating, but it is normal.

If you have been diagnosed with epilepsy, it's really helpful to create a seizure management plan with your treatment team. This should include post seizure management techniques that are suited to you.

The details of a post seizure care plan will vary from one person to the next, but could include things like:

  • Finding somewhere that you can go to sleep or rest
  • Having something to eat or drink
  • Heading home from work or school
  • Getting treated for any physical injuries sustained during a seizure
  • Taking painkillers approved by your doctor if you experience symptoms such as soreness or migraine
  • Changing your plans or activities until you feel fully recovered
  • Avoiding driving, operating machinery or lifting heavy objects
  • Taking additional seizure medication, if there’s a risk of having repeated seizures

If a person with epilepsy appears to be having a psychotic episode, then people around them should seek medical attention. Low doses of antipsychotic drugs are very effective for most people.

What to do after a seizure to feel better

Everyone’s experience of recovering from a seizure is unique to them. For example, some people may have cuts and bruises. Others may need to take medication. Or they may need to rest. It’s always valuable to speak to your physician for personalized advice. But here are some general ideas to help with recovering from a seizure:

1. Record information in your seizure diary

Once you feel able to, record your seizure in your seizure diary (you can do this in Epsy). Write down when and where the seizure happened, how you felt before and after, and any other information about your experience. This is helpful information for your doctor, but can also give you a greater sense of control. 

2. Treat any physical injuries

Depending on the kind of seizures you have, you may have physical injuries to address. Cuts and bites to your tongue and lips can be treated with ointments available at pharmacies - or by simply swilling a salt water solution around your mouth. 

Apply ice packs to bruises on your body, or use alternating hot/cold compresses for sore muscles. If you have any cuts or wounds, make sure they’re clean and apply dressings and antiseptic ointments. If you’re unsure about an injury, always seek medical attention. 

3. Don’t ignore your feelings

It is very common to feel sad, anxious or depressed after having a seizure. People sometimes feel embarrassed, frustrated or angry too. If you feel comfortable doing so, try talking to a friend or carer about these feelings - opening up can really help. 

4. Rest up

It’s always a good idea to take a break when recovering from a seizure. If you need, go home and sleep it off. If you’re at work or school, take some time away from your tasks, and go sit somewhere calm, relaxing and safe until you feel better, 

5. Water and food

After a seizure, you may have low energy levels. If so, eating a healthy snack (such as some fruit or a cereal bar) can help re-energize you. It’s always a good idea to drink water too. 

6. Set reminders on your phone

Many people find they are more forgetful than usual after a seizure. It’s a good idea to set reminders of important things you need to do each day on your phone, so you don’t forget. 

7. Take your medication

If you take epilepsy medication, don’t forget to take it when you are recovering from a seizure. Set a reminder on your smartphone to alert you every day. 

Having a post seizure care plan

Everybody’s post seizure symptoms, experiences, and situation are unique - and this is why it's really valuable to develop a personalized post seizure care plan. Speak to your treatment team or your doctor about creating one, and share it with people you are close to.

Epsy provides a useful place for you to record any information about your post seizure symptoms, and you can share these with your doctor to

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