Treatment strategies in the postictal state
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Published on: June 6, 2025
Gregory Krauss1, William H Theodore
1Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. gkrauss@jhmi.edu
Abstract:
Postictal behaviors and symptoms often require special assessment and treatment. We review risk factors for postictal delirium and psychosis and management of agitated and confused behaviors in patients after seizures. Medical and emergency staff require careful training to manage behaviors associated with postictal delirium and psychosis in order to protect patients while their confusion resolves. Treatment of postictal states requires recognition of underlying neurological and systemic disorders associated with seizures and delirium such as metabolic disorders and nonconvulsive seizures. There is incomplete information about the causes and optimal treatments for seizure-related psychosis, however, postictal behaviors can usually be managed safely.
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