349:(PET) scanning of radiolabelled ligands before, during, and after spontaneous seizures in humans. They found that opioid receptors were upregulated in the regions near the focus of the seizure during the ictal phase, gradually returning to baseline availability during the postictal phase. Hammers notes that cerebral bloodflow after a seizure cannot account for the increase in PET activity observed. Regional bloodflow can increase by as much as 70–80% after seizures but normalizes after 30 minutes. The shortest postictal interval in their study was 90 minutes and none of the patients had seizures during the scanning. It has been predicted that a decrease in opioid activity following a seizure could cause withdrawal symptoms, contributing to postictal depression. The opioid receptor connection with mitigating seizures has been disputed, and opioids have been found to have different functions in different regions of the brain, having both proconvulsive and anticonvulsive effects.
410:
it has been shown that sometimes cerebral blood flow is not proportionate to metabolism. While cerebral blood flow didn't change in the mouse hippocampus (the foci of seizures in this model) during or after seizures, increases in relative glucose uptake were observed in the region during the ictal and early postictal periods. Animal models are difficult for this type of study because each type of seizure model produces a unique pattern of perfusion and metabolism. Thus, in different models of epilepsy, researchers have had differing results as to whether or not metabolism and perfusion become uncoupled. Hosokawa's model used EL mice, in which seizures begin in the
239:. Following the typical postictal confusion and lethargy, the person gradually recovers to a normal lucid state. In persons who experience postictal psychosis, this "lucid phase" usually continues at least 6 hours (and up to a week) followed by the psychosis lasting as little as one hour to more than 3 months (the mean is 9–10 days). The psychosis is typically treated medically using
393:. With continued contractions under anaerobic conditions, the cells undergo lactic acidosis, or the production of lactic acid as a metabolic byproduct. This acidifies the blood (higher H+ concentration, lower pH), which has many impacts on the brain. For one, “hydrogen ions compete with other ions at the ion channel associated with N-methyl-d-aspartate (
344:
may be occurring during seizures and may be partially responsible for the weariness humans experience following a seizure. When humans were given naloxone in-between seizures, researchers observed increased activity on their EEGs, suggesting that opioid receptors may also be upregulated during human
409:
typically ensures that the correct amount of blood reaches the various regions of the brain to match the activity of the cells in that region. In other words, perfusion typically matches metabolism in all organs; especially in the brain, which gets the highest priority. However, following a seizure
315:
terminal and then exocytosed into the synaptic cleft in order to propagate the signal to the next neuron. While neurotransmitters are not typically a limiting factor in neuronal signaling rates, it is possible that with extensive firing during seizures neurotransmitters could be used up faster than
836:
Quote: "Patients who are aware of increased depression or tension prior to generalized tonic-clonic or limbic seizures occasionally report a feeling of euphoria or release during the postictal period atients with interictal or preictal depression can report relief or euphoria postictally, which is
278:
The postictal state can also be useful for determining the focus of the seizure. Decreased verbal memory (short term) tends to result from a seizure in the dominant hemisphere, whereas seizures in the non-dominant hemisphere tend to manifest with decreased visual memory. Inability to read suggests
262:
do not produce a postictal state and some seizure types may have very brief postictal states. Otherwise, the lack of typical postictal symptoms, such as confusion and lethargy following convulsive seizures, may be a sign of non-epileptic seizures. Usually such seizures are instead related to
203:
is a temporary regional loss of function in whatever region just experienced the seizure, and its manifestation depends on where the seizure was located. Loss of motor function is most common and can range from weakness to full paralysis. About 6% of patients who had
373:
Leftover inhibitory signals are the most likely explanation for why there would be a period in which the threshold for provoking a second seizure is high, and lowered excitability may also explain some of the postictal symptoms. Inhibitory signals could be through
903:
Absence ... seizures begin and end suddenly. There is no warning before the seizure, and immediately afterward the person is alert and attentive. This lack of a postictal period is a key feature that allows one to distinguish between absence and partial complex
169:-induced reversible alterations in neuronal function but not structure." Commonly after a seizure, a person feels mentally and physically exhausted for up to one or two days. The most common complaint is an inability to think clearly, specifically "poor
254:
Postictal bliss or euphoria is also reported following seizures. This has been described as a highly blissful feeling associated with the emergence from amnesia. Feelings of depression before a seizure may lead to postictal euphoria.
370:, a period of weeks or even months following a series of seizures in which seizures cannot be induced (using animal models and a technique called kindling, in which seizures are induced with repeated electrical stimulation).
916:
Hammers, Alexander; Asselin, Marie-Claude; Hinz, Rainer; Kitchen, Ian; Brooks, David J.; Duncan, John S.; Koepp, Matthias J. (14 April 2007). Newsom-David, John; Husain, Masud; Al-Chalabi, Ammar; Mallucci, Giovanna (eds.).
357:
It is possible that seizures cease spontaneously, but it is much more probable that some changes in the brain create inhibitory signals that serve to tamp down the overactive neurons and effectively end the seizure.
389:
of the blood could aid in ending the seizure and also depress neuron firing following its conclusion. As muscles contract during tonic-clonic seizures they outpace oxygen supplies and go into
141:
disorder. For most people with epilepsy, the interictal state corresponds to more than 99% of their life. The interictal period is often used by neurologists when diagnosing epilepsy since an
1012:
Hosokawa, Chisa; Ochi, Hironobu; Yamagami, Sakae; Yamada, Ryusaku (1 April 1997). Goldsmith, Stanley J.; Murphy, Dawn; Sonnemaker, Robert E.; Silver, Stacey; Tapscott, Eleanore (eds.).
223:
Postictal psychosis is a neuropsychiatric sequel to seizures of chronic epilepsy in adults. Tending to occur with bilateral seizure types it is characterized by auditory and visual
80:
period is the seizure itself; the interictal period is the time between seizures, when brain activity is more normal; and the preictal period is the time leading up to a seizure:
1030:
837:
consistent with the well-known beneficial effect of electroconvulsive shock therapy (ECT). Postictal hypomania can occur, particularly after repeated limbic seizures."
208:
experienced Todd's paresis afterward, with loss of motor function sometimes accompanied with temporary numbness, blindness, or deafness. Todd's paresis can also cause
1092:
316:
new ones could be synthesized in the cell and transported down the axon. There is currently no direct evidence for neurotransmitter depletion following seizures.
414:
and present similarly to the behaviors observed in human epileptic patients. If humans show similar uncoupling of perfusion and metabolism, this would result in
894:
898:
366:
has also been implicated as a molecule potentially involved in terminating seizures. Evidence for the theory of active inhibition lies in the postictal
1377:
1460:
295:
While it might seem that the neurons become “exhausted” after the near-constant firing involved in a seizure, the ability of the neuron to carry an
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635:
205:
49:. It usually lasts between 5 and 30 minutes, but sometimes longer in the case of larger or more severe seizures, and is characterized by
1424:
1085:
1354:
918:
1439:
1311:
1263:
576:
268:
109:(EEG), the recording during a seizure is said to be "ictal". The following definitions refer to the temporal relation with seizures.
220:
if the seizures began in the language-dominant hemisphere. Symptoms typically last about 15 hours, but can continue for 36 hours.
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42:
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following a seizure is not decreased. Neurons of the brain fire normally when stimulated, even after long periods of
1321:
279:
seizure foci in the language areas of the left hemisphere, and "after a seizure semivoluntary events as mundane as
418:
in the affected area, a possible explanation for the confusion and 'fog' patients experience following a seizure.
397:). This competition may partially attenuate NMDA receptor and channel mediated hyperexcitability after seizures.”
196:. At times, a person may be unaware of having had a seizure, and the characteristic migraine is their only clue.
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870:
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735:
Devinsky, Orrin (26 February 2008). Spencer, David; Jehi, Lara E.; Won, Michael; Danzer, Steve C. (eds.).
640:
379:
340:
immediately reverses this state, providing evidence that increased responsiveness or concentration of the
240:
181:, decreased verbal and interactive skills, and a variety of cognitive defects specific to individuals."
106:
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Some of postictal symptoms are almost always present for a period of a few hours up to a day or two.
150:
142:
362:
peptides have been shown to be involved in the postictal state and are at times anticonvulsive, and
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200:
178:
153:. Interictal EEG discharges are those abnormal waveforms not associated with seizure symptoms.
46:
851:. In Bromfield, Edward B.; Cavazos, José E.; Sirven, Joseph I.; Rogawski, Michael A. (eds.).
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990:
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1014:"Regional cerebral blood flow and glucose utilization in spontaneously epileptic EL mice"
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Fisher, Robert S.; Schachter, Steven C. (1 February 2000). Schachter, Steven C. (ed.).
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244:
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193:
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Mula, Marco; Monaco, Francesco (23 March 2011). Cavanna, A.E.; Trojano, Luigi (eds.).
378:(both fast and slow IPSPs), calcium-activated potassium receptors (which give rise to
272:
1510:
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1208:
1119:
858:
774:
766:
415:
174:
709:
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546:
325:
162:
62:
919:"Upregulation of opioid receptor binding following spontaneous epileptic seizures"
519:
284:
550:
862:
852:
411:
382:), hyperpolarizing pumps, or other changes in ion channels or signal receptors.
213:
117:
refers to the state immediately before the actual seizure, stroke, or headache.
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50:
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98:
70:
66:
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636:"The postictal state: a neglected entity in the management of epilepsy"
560:
465:
217:
166:
90:
28:
184:
Postictal migraine headaches are a major complaint among persons with
932:
649:
556:
461:
359:
94:
58:
17:
199:
Other symptoms associated with the postictal state are less common.
188:, and can have a variety of etiologies. One possible cause of these
847:
Bromfield, Edward B.; Cavazos, José E.; Sirven, Joseph I. (2006).
790:
685:
345:
seizures. To provide direct evidence for this, Hammers et al. did
77:
970:
586:
394:
328:, seizures are followed by unconsciousness and slow waves on an
312:
1074:
1031:
Society of
Nuclear Medicine and Molecular Imaging (SNMMI)
324:
In studies that stimulate seizures by subjecting rats to
34:
Altered state of consciousness after an epileptic seizure
737:"Postictal Psychosis: Common, Dangerous, and Treatable"
192:
is high intracranial pressure resulting from postictal
287:
to (that is on the same side as) the seizure focus."
895:
1453:
1417:
1363:
1340:
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1216:
1207:
1184:
1153:
1112:
165:defines the postictal state as "manifestations of
149:and other abnormalities known by neurologists as
89:refers to a physiologic state or event such as a
943:: Guarantors of Brain (charitable organization)/
899:NLM (United States National Library of Medicine)
555:. Conteporary neurology series (2nd ed.).
1086:
8:
125:refers to the state shortly after the event.
385:While not an example of active inhibition,
1213:
1093:
1079:
1071:
133:refers to the period between seizures, or
101:. The word originates from the Latin word
952:
806:
629:
627:
505:
311:Neurotransmitters must be present in the
1461:Citizens United for Research in Epilepsy
625:
623:
621:
619:
617:
615:
613:
611:
609:
607:
541:
539:
537:
438:
448:"Ictal and peri-ictal psychopathology"
336:. Administering the opiate antagonist
212:if the seizure included the bilateral
829:
7:
1378:Dentatorubral–pallidoluysian atrophy
251:can resolve the psychotic episodes.
1425:Sudden unexpected death in epilepsy
73:, and other disorienting symptoms.
1355:Complex partial status epilepticus
25:
1440:Psychogenic non-epileptic seizure
1312:Benign familial neonatal seizures
1264:Sleep-related hypermotor epilepsy
105:, meaning a blow or a stroke. In
775:10.1111/j.1535-7511.2008.00227.x
137:, that are characteristic of an
1400:Early myoclonic encephalopathy
1373:Progressive myoclonus epilepsy
849:"Chapter 2: Clinical Epilepsy"
834:Chapter 9: Periictal Phenomena
283:tend to be done with the hand
43:altered state of consciousness
1:
945:Oxford University Press (OUP)
1350:Epilepsia partialis continua
347:positron emission tomography
145:trace will often show small
1405:Juvenile myoclonic epilepsy
1383:Unverricht–Lundborg disease
1022:Journal of Nuclear Medicine
854:An Introduction to Epilepsy
1548:
1322:Myoclonic astatic epilepsy
332:(EEG), signs of postictal
26:
1473:Epilepsy Action Australia
871:American Epilepsy Society
763:American Epilepsy Society
1435:Landau–Kleffner syndrome
1269:Panayiotopoulos syndrome
867:United States of America
759:United States of America
235:, affective change, and
27:Not to be confused with
1317:Lennox–Gastaut syndrome
1199:Epilepsy and employment
641:Epilepsy & Behavior
569:Oxford University Press
241:atypical antipsychotics
1522:Electroencephalography
1249:Temporal lobe epilepsy
1169:Electroencephalography
670:10.1006/ebeh.2000.0023
380:afterhyperpolarization
320:Receptor concentration
107:electroencephalography
1254:Frontal lobe epilepsy
552:Seizures and Epilepsy
482:10.3233/ben-2011-0314
453:Behavioural Neurology
206:tonic–clonic seizures
1490:Epilepsy Research UK
1274:Vertiginous epilepsy
1194:Epilepsy and driving
1145:Epilepsy in children
954:10.1093/brain/awm012
391:anaerobic metabolism
330:electroencephalogram
151:subclinical seizures
1527:Medical terminology
1478:Epilepsy Foundation
1445:Epilepsy in animals
1125:Aura (warning sign)
210:anterograde amnesia
1365:Myoclonic epilepsy
1342:Status epilepticus
885:on 21 January 2011
401:Cerebral bloodflow
301:status epilepticus
269:psychogenic origin
158:Signs and symptoms
147:interictal spiking
1504:
1503:
1418:Related disorders
1413:
1412:
1259:Rolandic epilepsy
742:Epilepsy Currents
547:Engel, Jerome Jr.
368:refractory period
353:Active inhibition
307:Neurotransmitters
247:, and successful
179:short term memory
47:epileptic seizure
16:(Redirected from
1539:
1495:Epilepsy Society
1484:Epilepsy Outlook
1327:Epileptic spasms
1239:Gelastic seizure
1214:
1140:Neonatal seizure
1095:
1088:
1081:
1072:
1066:
1065:
1063:
1061:
1018:
1009:
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1002:
1000:
998:
989:. Archived from
956:
913:
907:
906:
892:
890:
881:. Archived from
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838:
827:
821:
820:
810:
732:
726:
725:
723:
721:
712:. Archived from
631:
602:
601:
595:
593:
543:
532:
531:
529:
527:
518:. Archived from
509:
443:
342:opiate receptors
297:action potential
260:Absence seizures
249:epilepsy surgery
21:
1547:
1546:
1542:
1541:
1540:
1538:
1537:
1536:
1532:Neurophysiology
1507:
1506:
1505:
1500:
1467:Epilepsy Action
1449:
1409:
1359:
1336:
1332:Febrile seizure
1297:Absence seizure
1278:
1234:Complex partial
1203:
1186:Personal issues
1180:
1165:Investigations
1161:Anticonvulsants
1149:
1135:Epileptogenesis
1130:Postictal state
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1099:
1069:
1059:
1057:
1016:
1011:
1010:
1006:
996:
994:
915:
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888:
886:
846:
845:
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832:, p. 332,
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824:
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729:
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632:
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589:
579:
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522:on 18 June 2015
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245:benzodiazepines
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39:postictal state
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32:
23:
22:
15:
12:
11:
5:
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1430:Todd's paresis
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1419:
1415:
1414:
1411:
1410:
1408:
1407:
1402:
1397:
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1393:Lafora disease
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1388:MERRF syndrome
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1302:Atonic seizure
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1229:Simple partial
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1176:Epileptologist
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993:on 2 June 2018
941:United Kingdom
908:
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716:on 2 June 2018
658:United Kingdom
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577:
565:United Kingdom
533:
470:United Kingdom
437:
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428:Ictal headache
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407:autoregulation
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399:
376:GABA receptors
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351:
321:
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273:pseudoseizures
225:hallucinations
201:Todd's paresis
194:cerebral edema
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33:
24:
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1454:Organizations
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1209:Seizure types
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1120:Seizure types
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947:: 1009–1016.
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859:West Hartford
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767:SAGE Journals
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662:Elsevier Inc.
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63:hypertension
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1284:Generalised
1033:: 613–616.
863:Connecticut
664:: P52–P59.
412:hippocampus
285:ipsilateral
281:nose wiping
135:convulsions
1511:Categories
1307:Automatism
1154:Management
830:Engel 2013
791:2001215107
686:sn99008772
434:References
267:or have a
237:aggression
214:hippocampi
130:Interictal
122:Post-ictal
51:drowsiness
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1039:0161-5505
963:0006-8950
904:seizures.
783:1535-7597
769:: 31–34.
678:1525-5050
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490:0953-4180
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405:Cerebral
364:adenosine
334:catalepsy
291:Mechanism
229:delusions
190:migraines
171:attention
114:Pre-ictal
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45:after an
1517:Epilepsy
1245:Epilepsy
1225:Seizures
1106:epilepsy
1102:Seizures
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702:12609127
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516:21447894
498:37773567
422:See also
387:acidosis
338:naloxone
233:paranoia
186:epilepsy
139:epilepsy
99:headache
71:migraine
67:headache
1060:22 July
1055:9098212
997:22 July
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937:England
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751:Chicago
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