"It was like someone cracked an egg on the top of my head and then drew a line on my body, turning one half off," Settle said.
"My body started drooping immediately. I tried to put my hands up to my face, but I could only move my left arm. I couldn't talk because part of my tongue was immobile. I tried to stand, but there was nothing.
"I was panicked. I let out this wail because I was so scared and the room went silent. All I could figure out how to say was 'Help'."
Settle later discovered that she'd suffered from a transient ischaemic attack, or a "ministroke", which produces similar symptoms to a regular stroke.
A series of scans concluded that half of Settle's brain had been blocked from blood flow and oxygen for years due to collated carotid arteries — meaning she'd essentially been a ticking time bomb.
"It could have happened at any time," said Settle. "It just so happened to happen a week before the biggest performance of my life."
The Broadway star adopted the long-established "show must go on" policy and decided to delay surgery in order to continue with her Oscars commitments, and only told a handful of people about the issue — including co-star Hugh Jackman, who Facetimed her daily for updates.
Following the showstopping performance, Settle finally had surgery in April, before undergoing months of recovery.
"I have a new brain and that's meant starting over," she explained.
"I needed a blood transfusion to help move, and then I spent the entire first month doing a lot of cognitive and physical therapy to relearn how to walk, talk, write, and live life again. I've been growing my memory, too. It's all a process and I'm still working on it daily."