When Paralysis Occurs After a Seizure

Many people who have seizures may feel fatigued or sleepy for hours or even days after having a seizure. Sometimes, people experience a condition called post-seizure paralysis or postictal paralysis, which is temporary weakness of part of the body after a seizure.

A woman touching her chest in pain

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Postictal paralysis can manifest as either partial weakness or complete paralysis and usually affects a specific part of the body. The paralysis typically lasts from one hour to 36 hours. While it can occur with any type of seizure, postictal paralysis usually affects people who have epilepsy, which is a condition in which people have recurrent seizures.

The Postictal State

A seizure is generally characterized by a decreased level of awareness, staring, or convulsions and 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 but is a period during which temporary neurological changes such as fatigue, extreme sleepiness, staring, headaches, confusion, and changes in behavior occur.

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
  • Numbness
  • Changes in vision or vision loss
  • Vision loss
  • Loss of bowel or bladder control
  • Confusion, drowsiness, and lack of responsiveness

If you experience sudden weakness, it is important to get medical attention right away, as this can be an emergency requiring urgent medical treatment.

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.


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 the brain, producing the 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.


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 it can be difficult to tell them apart.

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 optimal recovery. There are a number of medical tests that can support or confirm the diagnosis of postictal paralysis. Some of these tests include:

Treatment and Prevention

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

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.

A Word From Verywell

If you have been diagnosed with postictal paralysis, you and those who you spend time with should learn to recognize the signs and symptoms of your postictal paralysis, so that you can safely get 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.

2 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Institute of Neurological Disorders and Stroke. Todd's paralysis information page. Last reviewed March 27, 2019.

  2. Xu SY, Li ZX, Wu XW, Li L, Li CX. Frequency and pathophysiology of post-seizure Todd's paralysis. Med Sci Monit. 2020;26:e920751. doi: 10.12659/MSM.920751.

By Jose Vega MD, PhD
Jose Vega MD, PhD, is a board-certified neurologist and published researcher specializing in stroke.