A. While the character is seizing, keep them safe by clearing the area.

Seizures can look really scary, but most of the time they’ll stop on your own. If you want your character to look like they know what they’re doing, have them clear a space around the seizing character, moving furniture and other objects out of the way so that they can’t hit anything hard or sharp while they’re flailing around. Your character should also check for a medical bracelet before calling 911; seizures aren’t dangerous most of the time and people with epilepsy get seizures often enough that they would go bankrupt if an ambulance were called every time they seized (welcome to the American healthcare system!). And for the love of God, do not have them put anything in their mouth; the character biting their tongue is far preferable to them choking on a tongue depressor or biting off a well-meaning character’s finger. 

What about once they’re done seizing?

After a tonic-clonic seizure – what used to be a “grand mal” seizure – your character may remain unconscious for a few minutes. They may even snore. But they should wake up within a few minutes – any more than that is worrisome. However, they won’t be totally back to themselves when they wake either. Instead, they’ll be experiencing the final phase of a seizure, called the postictal phase.  

Postical State

Postictal states are a period of time during which your character’s brain is no longer actively seizing, but it isn’t back to normal either. Basically, it’s the time during which your character’s brain recovers after a seizure.

If your character is postictal, they’ll probably be drowsy and confused. They may also:

  • Feel weak or unable to move half their body (called “Todd’s paresis” or “Todd’s paralysis”)
  • Be unable to speak
  • Make repetitive motions, such as smacking their lips, rubbing their face, or picking at their skin.
  • Have a headache
  • Cough, spit, drool, or wipe their nose a lot
  • Feel nauseated and/or thirsty
  • Feel sad, embarrassed, or depressed
  • Be sore and physically exhausted

If your character had a seizure, they probably won’t remember the seizure itself (the “ictal period”) or the postictal period.

Not all seizures are tonic-clonic, and not all types of seizures have postictal periods. If your character doesn’t lose consciousness – such as if they’ve had a Focal Onset Aware seizure – they won’t experience a postictal state. Similarly, if your character has Absence Seizures, they will return to normal consciousness as soon as the seizure is over.

Want to learn more?

Interested in learning more about different types of seizures? Need more details on what it what it feels like to have a seizure? Want to know how medical professionals would diagnose and treat your character’s first seizure? Then check out Ch. 6: Syncope & Seizures of Illness & Injury, the second volume of my “Writer’s Guide to Medicine” series. Release date July 31, 2022!