Todd’s paralysis is neurological condition that presents as a period of paralysis following a seizure. It’s also called Todd’s paresis or postictal paresis. This period of temporary weakness in your body can last for a few seconds, a few minutes, or several hours.
The paralysis can be partial or complete. With complete paralysis, you won’t be able to feel the affected body part at all. With partial paralysis, you can still feel some sensation in the affected part of your body.
Todd’s paralysis tends to affect one side of the body at a time. Although Todd’s paralysis can mimic some symptoms of a stroke, it only occurs after a seizure. In most cases, Todd’s paralysis occurs in the part of the body that was affected by the seizure.
Symptoms of Todd’s paralysis include:
- weakness of a limb, such as your hand, arm, or leg
- slurred speech
Symptoms begin during the postictal state, which is a period of time after a seizure when you transition back to a normal state of awareness. This period can last from a few seconds to a few hours. The main symptom is weakness or a loss of feeling in parts of your body. It usually happens on one side, which is called hemiparesis. The symptoms are similar to those of a stroke, but the two conditions are vastly different.
Both strokes and seizures impact the function of your brain. The symptoms of Todd’s paralysis resolve themselves within 48 hours. Conversely, the effects of a stroke can be permanent and usually require rehabilitation after the event.
Todd’s paralysis symptoms don’t require rehab to go away. The weakness, numbness, and vision or speech difficulties should gradually go away on their own.
Causes and risk factors
Doctors don’t know what causes Todd’s paralysis. Because Todd’s paralysis is connected to epilepsy, researchers theorize that it addresses your brain’s recovery needs after a seizure. It remains unclear how, why, and if this is even what happens, however.
Not everyone who has epilepsy will experience Todd’s paralysis. There are some outstanding cases where people appear to have had Todd’s paralysis without an epileptic cause, but these cases are very rare. They’re being studied to help us understand more about the condition.
A seizure seems to be the only prerequisite trigger for an episode of Todd’s paralysis. Todd’s paralysis may accompany 6 percent of epileptic seizure cases in which a person loses consciousness. In one study, Todd’s paralysis lasted longer in people that were unconscious during seizure activity. You don’t have to be unconscious during a seizure for Todd’s paralysis to happen afterward, however. And if you’ve had Todd’s paralysis before, that doesn’t mean it will happen again after seizures going forward.
Even though Todd’s paralysis doesn’t affect a certain group of people with epilepsy more than others, there are factors that affect how often you have seizures. Getting enough sleep, staying adequately hydrated, and taking medication properly can all play into your risk of having more frequent seizures.
Diagnosis and treatment
If you experience a seizure for the first time, it’s normal to feel frightened and confused, especially if it was followed by a period of paralysis. You’ll need to follow up with your doctor. They will ask you questions to determine what happened.
Your doctor will then refer you to a neurological specialist, who will run tests to see if you have epilepsy. Electroencephalography is the most commonly used test to help doctors diagnose epilepsy. Blood tests, MRIs, and CT scans might also be part of the diagnostic process.
If you have a history of epilepsy and experience Todd’s paralysis for the first time, you should contact your epilepsy specialist. You may want to make sure that your epilepsy treatment options are still appropriate and address any concerns you have about medication dosage. Your doctor should always be up-to-date on your epilepsy symptoms so that they can continue to help you.
During Todd’s paralysis, there’s not much to do in terms of treatment. Try to rest as comfortably as possible and wait for the symptoms to go away. Time and rest are the only things known to resolve the symptoms.
People who experience Todd’s paralysis are expected to recover feeling in their affected body parts. If the seizure is severe, you may have lasting symptoms from the seizure’s effect on your brain. These side effects are connected to your seizure and are not a result of Todd’s paralysis. A neurologist who specializes in epilepsy will be able to assess how severe your seizure was, whether to expect seizures to continue, and if you need to be on antiseizure medication.