Table of ContentsView AllTable of ContentsAural PhaseIctal PhasePostictal Phase

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Table of Contents

Aural Phase

Ictal Phase

Postictal Phase

Seizure phases include the aural stage, the ictal stage, and the postictal stage. A seizure is a brief episode involving changes in consciousness and/or involuntary (not on purpose) shaking or jerking of the body.

If you or your child hasepilepsy, you mayexperience a seizure patternthat involves only the ictal phase or you may have a seizure pattern that includes other seizure phases as well. It is important to learn how to recognize these phases so that you can avoid injuries or harmful effects of a seizure.

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1:43Knowing What to Do When Someone Has a Seizure

1:43

Knowing What to Do When Someone Has a Seizure

The first stage of a seizure, anaura, is also described as the pre-ictal phase. This stage occurs immediately before the ictal stage of a seizure and it can last from a few seconds to an hour in duration. Most people are aware of their own symptoms during a seizure aura.

You may or may not have an aura prior to your seizures. Most people who have a pre-seizure aura experience the same type of aura every time.

If your child typically has a seizure aura prior to their seizure, you may learn to recognize subtle signs of their aura or you can ask your child if they notice a recurrent pattern of symptoms before they have an obvious seizure.

An aura can involve symptoms of fatigue, visual changes, a sense of detachment from reality, and altered perceptions or sensory hallucinations ofdistorted taste, unusual sounds, or the feeling of tingling. Transient involuntary movements, like the brief muscle twitches ofmyoclonic seizures, can occur.

What You Can DoPeople who experience seizures, even those with an aura, can make lifestyle modifications to avoid potentially dangerous activities like climbing stairs or handling sharp objects. Lowering overall risk is important, which includes driving in many cases. Note that some states require a specific seizure-free period in order to have a driver’s license.

What You Can Do

People who experience seizures, even those with an aura, can make lifestyle modifications to avoid potentially dangerous activities like climbing stairs or handling sharp objects. Lowering overall risk is important, which includes driving in many cases. Note that some states require a specific seizure-free period in order to have a driver’s license.

Can People With Epilepsy Drive?

The most prominent and visibly apparent phase of a seizure is described as theictal phase. During this phase, you may experience alterations in consciousness, involuntary movements—or both. A seizure can be described as aconvulsive seizure(with shaking or jerking movements) or a non-convulsive seizure (without any unusual physical movements).

Involuntary movements may involve your whole body, or one side of your face, arm, or leg. Typically, the muscle movements are rhythmic and repetitive.

You may or may not be aware of your symptoms during the ictal phase of your seizures.

The ictal phase typically lasts between a few seconds to a few minutes. Usually, the ictal phase of a seizure resolves on its own. In rare instances, this phase may be prolonged and might not cease until you take rapid-acting anti-seizure medication—this type of continuous seizure is calledstatus epilepticus.

If you have epilepsy, the diagnosis of your seizure type and your treatment strategy is typically based on the features of your ictal phase.

Common seizure types include:

You can experience more than one seizure type if you have epilepsy.

Your ictal symptoms will likely correspond to the pattern seen on yourelectroencephalogram (EEG)during this phase. Your EEG is expected to show erratic electrical activity during the ictal phase of a seizure. These changes may correspond to one portion of the brain in focal seizures or may involve the whole brain in an absence seizure or a generalized tonic-clonic seizure.

Keep in mind that routine EEGs can be normal even if you have a seizure diagnosis. You also can have normal results if the EEG doesn’t capture erratic brain activity during your ictal phase, or in the case of psychogenic non-epileptic seizures (PNES) with similar symptoms.

What You Can DoBe sure to describe this phase to your healthcare provider if you recall any of it. If a family member has witnessed your ictal phase, it is important to report the details to your medical team, as the events in this phase guidetreatment.

Be sure to describe this phase to your healthcare provider if you recall any of it. If a family member has witnessed your ictal phase, it is important to report the details to your medical team, as the events in this phase guidetreatment.

The postictal stageoccurs after the ictal phase of a seizure. You can have a variety of symptoms during the postictal stage of a seizure. You can be conscious or unconscious during this stage—and your level of consciousness during your postictal phase might or might not correlate to your level of consciousness during your ictal stage.

It is common to feel very tired after a seizure and you may need to sleep for several days before finally feeling rested. Sometimes you may be completely unarousable (unable to be woken up) after a seizure. It is also common to be confused (postictal confusion).

And some people experience partial paralysis (weakness) of an arm or leg during the postictal phase of a seizure. This paralysis, often described asTodd’s paralysis, can last for several hours, and may even last for days. Todd’s paralysis often corresponds to the area of the brain in which the seizure began, and it is sometimes considered a sign of focal seizures.

What You Can DoBe aware that you may get groggy as you are recovering from a seizure. Take it easy and get enough rest so that you can fully recover.

Be aware that you may get groggy as you are recovering from a seizure. Take it easy and get enough rest so that you can fully recover.

A Word From Verywell

Your seizure stages can be worrisome for you, especially if you have not experienced them before. You should discuss all of your seizure symptoms with your healthcare provider. Over time, you may begin to recognize your seizure pattern—including all of the stages.

Knowing the sequence of your seizure phases can help you manage your epilepsy and can help you assess how well your anti-epilepsy medication is working.

Risks and Complications of Seizures

6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Asadi-Pooya AA, Farazdaghi M.Aura: epilepsy vs. functional (psychogenic) seizures.Seizure. 2021 May;88:53-55. doi:10.1016/j.seizure.2021.03.026.Epilepsy Foundation.Driving and transportation.Crunelli V, Lőrincz ML, McCafferty C, Lambert RC, Leresche N, Di Giovanni G,et al.Clinical and experimental insight into pathophysiology, comorbidity and therapy of absence seizures.Brain. 2020 Aug 1;143(8):2341-2368. doi:10.1093/brain/awaa072.Centers for Disease Control and Prevention.Types of Seizures.Jafari A, Rezaei Tavirani M, Parvareshi Hamrah M, Ahmadi Karvigh S, Bashi Zadeh Fakhar H.Psychogenic Non-Epileptic Seizures; a Narrative Review.Arch Acad Emerg Med. 2020 Jan 20;8(1):e10. PMID: 32607501;Bateman LM, Mendiratta A, Liou JY, et al.Postictal clinical and electroencephalographic activity following intracranially recorded bilateral tonic-clonic seizures.Epilepsia. 2019;60(1):74-84. doi:10.1111/epi.14621

6 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Asadi-Pooya AA, Farazdaghi M.Aura: epilepsy vs. functional (psychogenic) seizures.Seizure. 2021 May;88:53-55. doi:10.1016/j.seizure.2021.03.026.Epilepsy Foundation.Driving and transportation.Crunelli V, Lőrincz ML, McCafferty C, Lambert RC, Leresche N, Di Giovanni G,et al.Clinical and experimental insight into pathophysiology, comorbidity and therapy of absence seizures.Brain. 2020 Aug 1;143(8):2341-2368. doi:10.1093/brain/awaa072.Centers for Disease Control and Prevention.Types of Seizures.Jafari A, Rezaei Tavirani M, Parvareshi Hamrah M, Ahmadi Karvigh S, Bashi Zadeh Fakhar H.Psychogenic Non-Epileptic Seizures; a Narrative Review.Arch Acad Emerg Med. 2020 Jan 20;8(1):e10. PMID: 32607501;Bateman LM, Mendiratta A, Liou JY, et al.Postictal clinical and electroencephalographic activity following intracranially recorded bilateral tonic-clonic seizures.Epilepsia. 2019;60(1):74-84. doi:10.1111/epi.14621

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Asadi-Pooya AA, Farazdaghi M.Aura: epilepsy vs. functional (psychogenic) seizures.Seizure. 2021 May;88:53-55. doi:10.1016/j.seizure.2021.03.026.Epilepsy Foundation.Driving and transportation.Crunelli V, Lőrincz ML, McCafferty C, Lambert RC, Leresche N, Di Giovanni G,et al.Clinical and experimental insight into pathophysiology, comorbidity and therapy of absence seizures.Brain. 2020 Aug 1;143(8):2341-2368. doi:10.1093/brain/awaa072.Centers for Disease Control and Prevention.Types of Seizures.Jafari A, Rezaei Tavirani M, Parvareshi Hamrah M, Ahmadi Karvigh S, Bashi Zadeh Fakhar H.Psychogenic Non-Epileptic Seizures; a Narrative Review.Arch Acad Emerg Med. 2020 Jan 20;8(1):e10. PMID: 32607501;Bateman LM, Mendiratta A, Liou JY, et al.Postictal clinical and electroencephalographic activity following intracranially recorded bilateral tonic-clonic seizures.Epilepsia. 2019;60(1):74-84. doi:10.1111/epi.14621

Asadi-Pooya AA, Farazdaghi M.Aura: epilepsy vs. functional (psychogenic) seizures.Seizure. 2021 May;88:53-55. doi:10.1016/j.seizure.2021.03.026.

Epilepsy Foundation.Driving and transportation.

Crunelli V, Lőrincz ML, McCafferty C, Lambert RC, Leresche N, Di Giovanni G,et al.Clinical and experimental insight into pathophysiology, comorbidity and therapy of absence seizures.Brain. 2020 Aug 1;143(8):2341-2368. doi:10.1093/brain/awaa072.

Centers for Disease Control and Prevention.Types of Seizures.

Jafari A, Rezaei Tavirani M, Parvareshi Hamrah M, Ahmadi Karvigh S, Bashi Zadeh Fakhar H.Psychogenic Non-Epileptic Seizures; a Narrative Review.Arch Acad Emerg Med. 2020 Jan 20;8(1):e10. PMID: 32607501;

Bateman LM, Mendiratta A, Liou JY, et al.Postictal clinical and electroencephalographic activity following intracranially recorded bilateral tonic-clonic seizures.Epilepsia. 2019;60(1):74-84. doi:10.1111/epi.14621

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