What is Todd’s paralysis? – Medical News
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What is Todd’s paralysis?

Todd’s paralysis is experienced by some people with epilepsy. It happens after a seizure when it becomes impossible to move all or part of the body.

Epilepsy is a condition that causes electrical activity in the brain that can stop it working for a short time. The result is what is known as a seizure, convulsion, or fit.

There is no clear cause of Todd’s paralysis. Depending on the part of the brain that is affected, symptoms can include temporary problems with sight or speech, as well as loss of movement.

In rare cases, Todd’s paralysis affects people who do not have epilepsy, such as those who have had a head injury.

In this article, we find out more about the condition, its symptoms, and what might cause it.

What is Todd’s paralysis?

Todd's paralysis
Todd’s paralysis commonly affects one hand, arm, or leg, but it may also affect the whole body.

Todd’s paralysis is also referred to as Todd’s paresis, Todd’s palsy, or postictal paresis. It is a neurological condition, meaning it relates to the brain and nerves.

Different parts of a person’s brain control different processes and activities in their body, such as speech or movement.

Most people who experience Todd’s paralysis have epilepsy, and symptoms occur immediately after a seizure. The brain takes time to recover from a seizure, and this can have an impact on the body.

Todd’s paralysis commonly affects one hand, arm, or leg, but the condition can affect the whole body. The effects can range from a weakness in one part of the body to a full loss of movement and sensation.

The condition can affect sight and speech. A person experiencing Todd’s paralysis may be unable to speak, or have slurred speech. They may be unable to see, experience blurred vision, or see flashing lights or colors.


Symptoms

Epileptic seizures have different stages:

  1. An aura or warning, although all who have epilepsy will not experience this.
  2. The seizure itself, which is known as the ictal phase.
  3. Recovery from the seizure, known as the postictal phase.

Todd’s paralysis happens during the recovery phase, which is why it is sometimes known as postictal paralysis.

Some people will feel back to normal immediately after an epileptic seizure, while for others it can take minutes or hours to recover.

During the recovery time from a seizure, it is common for a person with epilepsy to have symptoms that can include confusion, tiredness, or dizziness.

Todd’s paralysis is a less common experience after a seizure. Depending on which part of the brain is recovering, different parts of the body will be affected by paralysis.

A person experiencing Todd’s paralysis will be unable to move part or all of their body. The condition usually only happens on one side of the body so can be confused with a stroke.

Paralysis can last between 30 minutes and 36 hours, after which feeling and movement will return completely. The average time for paralysis to last is 15 hours.

Differences from stroke

Todd’s paralysis usually only affects one side of the body, causing weakness or a loss of sensation, and can make speech slurred. Stroke shares all these symptoms. Consequently, Todd’s paralysis can be easily confused with a stroke, but it needs different treatment.

Stroke is a medical condition requiring emergency care. Blood supply to the brain needs to be restored, urgently, with medication or surgery.

A stroke will take time to recover from, and many people need rehabilitation. Their rehabilitation may mean support to enable them to resume normal life and be able to speak, grip things, or walk again.

In contrast, Todd’s paralysis will go away after a relatively short time and usually has no lasting impact. It is linked to epilepsy, a condition that can be managed in most cases.

Causes and risk factors

3d diagram of the brain
Theories suggest that Todd’s paralysis may be caused by the motor centers of the brain slowing down.

It is not clear what causes Todd’s paralysis.

Theories suggest that it may be due to processes in the brain that slow down brain activity. The areas of the brain that can be particularly affected are the motor centers, which are responsible for telling the body to move.

In rare cases, Todd’s paralysis may happen after a head injury. It can be mistaken for a symptom of the brain injury and treated accordingly.

Not everyone who has epilepsy will experience Todd’s paralysis. No clear risk factors have been found that mean certain people will be more likely to have the condition than others.

Because Todd’s paralysis happens immediately after a seizure, fewer seizures will mean that paralysis also occurs less often. A person can reduce the number of seizures they have by ensuring their epilepsy is managed with medication and self-care, including getting enough sleep.


Diagnosis

If someone has a seizure for the first time, they should see a doctor, as soon as they can. They may be referred to a brain and nerve specialist known as a neurologist. It should be remembered that there are many reasons for seizures and epilepsy is not their only cause.

Epilepsy can be hard to diagnose, so describing a seizure in detail can help. Tests may be needed to check the brain for electrical activity or any damage.

If a person has symptoms of Todd’s paralysis and has already been diagnosed with epilepsy, they should seek medical advice. The doctor or neurologist will ask questions about what happens after a seizure, and may check that medication is correct.

Treatment

Neurologist writing notes
A patient may be referred to a neurologist if they have a seizure for the first time.

There are currently no treatments available for Todd’s paralysis. However, controlling a person’s seizures will reduce the number of times they experience paralysis.

Treatment for epilepsy focuses on stopping or reducing seizures. Medication that changes the level of chemicals in the brain helps to control seizures in around 70 percent of people.

Some of those with epilepsy have clear triggers for their seizures, such as a lack of sleep or flickering lights, and can avoid these to prevent seizures from happening.

Some people may be able to tell when they are about to have a seizure. This awareness is known as a warning or aura and can have a range of symptoms, including:

  • an unusual smell or taste
  • an intense feeling of fear or delight
  • an unsettled feeling in the stomach

If a person with epilepsy feels they are about to have a seizure, they should try to get into a position where they cannot hurt themselves. This might include lying on a floor away from walls and furniture and loosening clothes that are tight around the neck. These precautions can help to avoid injuries and aid breathing if a seizure occurs.

If Todd’s paralysis happens after a seizure, a person should rest in as comfortable a position as possible until it goes away.

People should seek medical treatment the first time they experience the condition and ask the doctor what might happen with any future seizures and paralysis.


Outlook

Todd’s paralysis is easily confused with a stroke, but ends much more quickly and has no lasting symptoms. It can be diagnosed if it happens directly after a seizure.

A person with epilepsy who experiences Todd’s paralysis should rest while symptoms pass.

It is often possible to reduce the number of seizures someone has with the help of medication, self-care, and by pinpointing triggers, such as stress or tiredness.

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