Postparoxysmal twilight state

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The postictal twilight state (also: postictal confusion or postparoxysmal twilight state) can occur after a generalized tonic-clonic epileptic seizure or after a focal seizure with impaired consciousness (complex-focal or psychomotor ), but more often it follows a series of seizures.

The most noticeable symptoms are a disturbance of consciousness , an impaired attention and disorganization in thinking and acting. The qualitative awareness can be narrowed, but the quantitative awareness ( vigilance ) can also be reduced. The postictal twilight state is formally a delirium . It is one of the rare examples of a qualitative disorder of consciousness.

Correspondingly, the people affected are slowed down in their thought processes and often in their entire behavior and their ability to perceive is limited. Often they fail to recognize the prompting character of a situation or the meaning of objects of perception and show excessive reactions to simple, rough stimuli, such as touching or moving other people. They experience this as threatening and react with fearful flight or aggressive defense e.g. B. in the case of well-intentioned contact by third parties. Left alone, the affected people show a calm and helplessness that they themselves experience as very unpleasant. The motor skills are noticeably clumsy and undifferentiated in this twilight state.

After many seizures, a brief period of confusion occurs, e.g. B. after a nonconvulsive status epilepticus, but a longer duration - up to a week - is also possible, especially in older people.

Another post-paroxysmal phenomenon is e.g. B. Todd's palsy .

Individual evidence

1. ^ Gregory Krauss, William H. Theodore: Treatment strategies in the postictal state . In: Epilepsy Behav. , 2010 Oct; 19 (2), pp. 188-190
2. ^ KJ Fagan, SI. Lee: Prolonged confusion following convulsions due to generalized nonconvulsive status epilepticus . In: Neurology , 1990, 40, pp. 1689-1694
3. ↑ JW Godfrey, MA Roberts, FI. Caird: Epileptic seizures in the elderly: II. Diagnostic problems . In: Age Aging , 1982, 11, pp. 29-34

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