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Overview

Todd’s paresis, (aka postictal paresis or postictal paralysis) is a temporary disorder that present with a focal neurological deficit after a seizure – for example – limb weakness.

As well as limb signs, it can also cause speech problems and visual or eye movement problems. It can last anywhere from a few seconds up to about 48 hours after a seizure. It typically affects a single limb. It resolve spontaneously.

It is important to take a careful history and thorough examination to rule out another case – particularly stroke, or in the case of seizure with a head stroke – intracranial bleed. CT scan and / or MRI of the brain may be indicated to rule out a more sinister cause.

It is most common after a focal seizure, but can present after any epileptic seizure.

There is no specific treatment. The condition resolves by itself with time, usually within 48 hours. Patients may require admission to hospital for a period of observation until symptoms have resolved.

Differentials

  • Stroke
  • Intracranial bleed
  • Functional neurological disorder

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