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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(09): s00451811625
DOI: 10.1055/s-0045-1811625
Original Article

Postictal status and clinical variables in adults with epilepsy

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Funding Scientific initiation - FAPESP n° 2023/03548-9.
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Abstract

Background

Symptoms in the postictal period are often neglected by professionals and patients/family members.

Objective

To relate the characteristics of the postictal period with the clinical variables of adult patients with epilepsy.

Methods

Prospectively, the clinical characteristics of the postictal period were related to the clinical variables and the scores on the Hospital Anxiety and Depression Scale (HADS) and Mini-Mental State Examination (MMSE) of 70 patients with epilepsy.

Results

The mean age was 47.6 years old, and 34 (48.6%) patients were male, the mean age at onset of epilepsy was 20.3 years old, the epileptic syndrome was structural in 48 cases, the mean score in the MMSE was 23.6, the mean score in the HADS-anxiety was 7.3, and in the HADS-depression it was 5.6. Postictal manifestation occurred in 59 (84.2%) cases, with prolonged duration in 22 (37.2%) cases. There was a difference in the duration and presence of postictal manifestation according to age at the onset of epilepsy. Higher HADS-anxiety scores were associated with the presence of confusion in the postictal period (t-test; 9.3 ± 6.8 versus 5.8 ± 4.8; p = 0.015). Lower MMSE scores were related to postictal anxiety and sleepiness/headache/confusion. Left-sided epileptiform activity (EA) was associated with postictal sleepiness/headache/confusion. There was a difference in postictal manifestation according to epileptic syndrome.

Conclusion

The characteristics of the postictal period differed according to the age of onset, the type of seizure, and the epileptic syndrome. Different symptoms in the postictal period were associated with the scores on HADS anxiety, MMSE, and left-sided EA on the electroencephalogram.

Keywords

Epilepsy - Seizures - Confusion

Data Availability Statement

The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.


Authors' Contributions

Conceptualization: GMAST; Investigation: GMAST; Methodology: GMAST, CFA; Project administration: GMAST, CFA; Supervision: GMAST, CFA; Writing - original draft: GMAST, CFA; Writing - review & editing: GMAST, CFA.


Editor-in-Chief: Hélio A. G. Teive. https://orcid.org/0000-0003-2305-1073.


Associate Editor: Marlon Wycliff Caeira. https://orcid.org/0000-0001-9094-4141.




Publikationsverlauf

Eingereicht: 11. Februar 2025

Angenommen: 28. Juni 2025

Artikel online veröffentlicht:
08. September 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Cecília Fusco Agostinho, Glória M. A. S. Tedrus. Postictal status and clinical variables in adults with epilepsy. Arq Neuropsiquiatr 2025; 83: s00451811625.
DOI: 10.1055/s-0045-1811625