What is Todd’s paralysis?

Some people with an epilepsy suffer Todd’s paralysis. It occurs after a seizure when the whole or part of the body is impossible to move.

Epilepsy is a condition that causes the brain to have electrical activity which can stop it from working for a short time. The result is what is termed a seizure, seizure or fit.

The cause of Todd’s paralysis is not clear. Symptoms can include temporary problems with sight or speech, as well as loss of movement depending on the part of the brain that is affected.

In rare cases, Todd’s paralysis affects individuals who have no epilepsy, such as those who have been hit to the head.

We find out more about the condition, its symptoms and what could cause it in this article.

What is Todd’s paralysis?

Todd’s paralysis commonly affects one hand, arm, or leg, but it may also affect the whole body.
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 disorder may have an effect on sight and speech. An individual suffering from Todd’s paralysis may not be able to speak, or may have slurred speech. You may not be able to see, experience blurred vision, or see lights or colors flashing.

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 healing process and this is why it is often referred to as postictal paralysis.

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

It is normal for a person with epilepsy to experience symptoms during the recovery period from a seizure that may include confusion, weakness, or dizziness.

Todd’s paralysis after a seizure, is a less common occurrence. The paralysis can affect various parts of the body depending on which part of the brain is recovering.

A person experiencing Todd’s paralysis can not move part or all of his or her body. The condition normally occurs only on one side of the body so it can be confused with a stroke.

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

Differences from stroke

Todd’s paralysis usually affects only one side of the body, causing weakness or loss of feeling, and can slurred speech. Stroke has all those symptoms in common. Therefore Todd’s paralysis can easily be confused with a stroke, but it requires different treatment.

Stroke is a medical condition which requires emergency treatment. Blood flow to the brain must be restored, with treatment or surgery as a matter of urgency.

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 a 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 paralysis for Todd.

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

Todd’s paralysis can, in rare cases, occur after a head injury. It can be mistaken for a brain injury symptom, and should be treated accordingly.

Not everyone suffering from epilepsy will experience Todd’s paralysis. There have been no established risk factors that suggest some individuals are more likely to have the disease than others.

Because Todd’s paralysis occurs immediately after a seizure, less seizures will mean paralysis also occurs less frequently. A individual may reduce the amount of seizures they have by taking medication and self-care to ensure their epilepsy is handled, including having 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

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

There are currently no available remedies for Todd’s paralysis. Control of a person’s seizures, however, can reduce the amount of times that they suffer paralysis.

Epileptic treatment focuses on halting or reducing seizures. Medication that increases the amount of chemicals in the brain helps in about 70 percent of people manage seizures.

Some epilepsy patients have specific causes for their seizures, such as a lack of sleep or flickering lights, and may avoid these to prevent seizures.

Some people might tell when they’re about to get a seizure. This awareness is called a warning or an aura and may 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 it progresses much sooner and has no permanent effects. If this occurs immediately after a seizure it can be treated.

A person with epilepsy who has Todd’s paralysis should rest until symptoms have passed.

With the aid of medicine, self-care, and by recognizing causes, such as stress or fatigue, it is also possible to reduce the amount of seizures someone has.

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