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Epilepsy: New insights into mysterious postictal disorders!
The University of Bonn is researching postictual disorders and their connection to epileptic seizures. The latest studies provide important insights.
Epilepsy: New insights into mysterious postictal disorders!
On September 19, 2025 there will be important news from the world of epilepsy research. A research team from the Department of Epileptology at the University Hospital of Bonn (UKB) postulated in a recent study that postictual disorders may not be directly related to epileptic seizures. These disorders are symptoms that occur after a seizure and can include symptoms such as confusion, difficulty speaking and understanding, and disorientation. Sufferers may be at risk of walking around disoriented, which is particularly risky if they are near roads.
Prof. Michael Wenzel, the leader of the study, explains that the exact relationship between seizures and these postictal disorders is still unclear. Researchers have gained insight into the development of epilepsy, particularly after viral encephalitis, using high-resolution fluorescence microscopy, electrophysiology and optogenetics. They discovered slow waves of depolarization in the hippocampus, which could be responsible for postictual disorders but do not explain the seizures themselves.
Relationship between seizures and postictural disorders
The slow depolarization waves, known from neurological diseases such as migraines, could be the key to understanding postictal disorders. These waves, which are typically filtered out in clinical EEG, may be more common in the hippocampus than in the neocortex. This may explain why postictual symptoms sometimes occur independently of epileptic seizures. The term “spreading depolarization” (SD) describes a condition in which the neuronal membrane potential collapses, which can paralyze the affected network for minutes to hours.
The study calls for a reassessment of previous research that did not take SD into account. There is debate as to whether the international EEG standard should be modernized to make these waves visible in clinical EEG. Evidence for seizure-associated SD has also been found in deep human brain regions. Such findings could revolutionize current understanding of how epileptic seizures and postictual disorders interact.
Variety of seizure forms
When it comes to epileptic seizures, there are a variety of presentations, divided into two main categories: generalized and partial (focal) seizures. In generalized seizures, the entire brain is affected from the start. In contrast, focal seizures occur in specific areas of the brain.
Numerous subtypes exist within these categories. Generalized seizures include, for example, the dramatic grand mal seizure, which progresses in several stages, as well as the shorter and unspectacular petit mal seizures. Focal seizures include simple focal seizures, which are divided into motor and sensory categories, and complex focal seizures, which are often accompanied by behavioral changes.
| Seizure types | Description |
|---|---|
| Great | Proceeds in several stages, including aura, tonic and clonic stages and terminal sleep. |
| Little time | Short attacks, often in children, without convulsions, characterized by loss of consciousness. |
| Simple focal seizures | Cause twitches or abnormal sensations in specific areas of the brain. |
| Complex focal seizures | Twilight states, often with amnesia, lasting from minutes to 20 minutes. |
This comprehensive information about the different types of seizures and postictal disorders highlights the complexity of epilepsy and the need for further research. While the study results of the Bonn research team open up new perspectives, work on the diagnosis and treatment of epilepsy remains a central concern of the medical community.
For more information about epilepsy, see epi.ch and elkezagadzki.blog. For details about the current study, please visit uni-bonn.de.