Todd’s Paralysis, Todd’s Paresis
Todd’s Paralysis, Todd’s Paresis
Todd’s paralysis (Todd’s paresis) is a transient localized weakness (usually hemiparesis), lasting seconds to minutes (exceptionally 24 to 48 hours), observed following a focal motor seizure or Jacksonian seizure originating in the central motor strip, or febrile convulsion, a phenomenon first described by RB Todd in 1854. The pattern and duration of post-ictal signs is quite heterogeneous. Aphasia is also described. A postictal "paralytic" conjugate ocular deviation may be observed after adversive seizures. Todd’s paresis is of localizing value, being contralateral to the epileptogenic hemisphere.
The differential diagnosis of transient postictal hemiparesis includes stroke, hemiplegic migraine, and, in children, alternating hemiplegia.
References
Binder DK. A history of Todd and his paralysis. Neurosurgery 2004; 54: 480-486
Kellinghaus C, Kotagal P. Lateralizing value of Todd’s palsy in patients with epilepsy. Neurology 2004; 62: 289-291
Rolak LA, Rutecki P, Ashizawa T, Harati Y. Clinical features of Todd’s post-epileptic paralysis. Journal of Neurology, Neurosurgery andPsychiatry 1992; 55: 63-64
Cross References
