Todd's palsy

Classification according to ICD-10
G83.8	Other specified paralysis syndromes
ICD-10 online (WHO version 2019)

The Todd'sche (or toddsche) paralysis ( syn : Todd'sche paresis , epileptic hemiplegia , epileptic paralysis , post-ictal paresis ) is a temporary paralysis phenomenon and one of the postictal changes.

It occurs after focal (or partial) seizures that also affect the motor cerebral cortex of the frontal lobe ( motor focal seizures ). In this case, forced electrical discharges in the part of the brain that is responsible for controlling movement lead to muscle twitching that is usually limited to one side of the body . After such an attack, persistent weakness of the corresponding body parts ( postictal paresis ) can be observed in about 13% of cases . They can last from minutes to hours, more rarely several days. Such postictal pareses have also been observed after generalized seizures ( grand mal ).

The cause is unknown; no specific therapy is necessary. However, it is important to distinguish it from the diagnosis of ischemic stroke .

This phenomenon is named after the Irish doctor Robert Bentley Todd (1809 - 1860), who described it in an 1849 publication in the " Lumleian Lectures ". He went into more detail on the phenomenon of epileptic hemiplegia in his work " Clinical Lectures of Paralysis " from 1855.

Earlier descriptions originate from a. In 1803 by the British doctor and scientific writer Thomas Beddoes , in 1818 by the French internist Pierre Blaud and in 1822 by the British doctor and ethnologist James Cowles Prichard .

Literature and Sources

^ DK Binder: A history of Todd and his paralysis. In: Neurosurgery . 2004 Feb; 54 (2), pp. 480-486. PMID 14744294
↑ P. Gallmetzer, F. Leutmezer, W. Serles, E. Assem-Hilger, J. Spatt, C. Baumgartner: Postictal paresis in focal Epilepsies - incidence, duration, and causes: a video-EEG monitoring study. In: Neurology. 2004 Jun 22; 62 (12), pp. 2160-2164. PMID 15210875
↑ Todd RB .: On the pathology and treatment of convulsive diseases. In: Lond Med Gaz . tape 8 , 1849, pp. 661-671, 724-729, 766-772, 815-822, 837-846 .
^ Todd RB .: Clinical Lectures on Paralysis, Disease of the Brain and other Affections of the Nervous System. Lindsay & Blakiston, Philadelphia 1855.
↑ Beddoes T .: Hygeia: or Essays Moral and Medical, on the Causes Affecting the Human State of our Middling and affluent classes. Vol 3. J. Mills for R. Phillips, Bristol / London 1803, pp. 196 .
^ Clark LP .: Clinical studies in epilepsy. In: Arch Neurol Psychopathol . tape 2 , 1899, pp. 321-471 .
^ Prichard JC .: A Treatise on Diseases of the Nervous System. Part the first, composing convulsive and maniacal affections. T. & G. Underwood, London 1822.

[1] DK Binder: A history of Todd and his paralysis. In: Neurosurgery . 2004 Feb; 54 (2), pp. 480-486. PMID 14744294

[2] P. Gallmetzer, F. Leutmezer, W. Serles, E. Assem-Hilger, J. Spatt, C. Baumgartner: Postictal paresis in focal Epilepsies - incidence, duration, and causes: a video-EEG monitoring study. In: Neurology. 2004 Jun 22; 62 (12), pp. 2160-2164. PMID 15210875

[3] Todd RB .: On the pathology and treatment of convulsive diseases. In: Lond Med Gaz . tape 8 , 1849, pp. 661-671, 724-729, 766-772, 815-822, 837-846 .

[4] Todd RB .: Clinical Lectures on Paralysis, Disease of the Brain and other Affections of the Nervous System. Lindsay & Blakiston, Philadelphia 1855.

[5] Beddoes T .: Hygeia: or Essays Moral and Medical, on the Causes Affecting the Human State of our Middling and affluent classes. Vol 3. J. Mills for R. Phillips, Bristol / London 1803, pp. 196 .

[6] Clark LP .: Clinical studies in epilepsy. In: Arch Neurol Psychopathol . tape 2 , 1899, pp. 321-471 .

[7] Prichard JC .: A Treatise on Diseases of the Nervous System. Part the first, composing convulsive and maniacal affections. T. & G. Underwood, London 1822.