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Todd’s Paralysis: Causes, Symptoms, Treatment, How is Todd’s Paralysis Different From Stroke?

What is Todd’s Paralysis?

Todd’s paralysis or Todd’s paresis is a neurological condition that occurs after a seizure as the brain takes time to recover from the seizure.(1) It mostly affects people with epilepsy. In this condition, a person is temporarily unable to move all or a few body parts. It is a temporary weakness that lasts for a few minutes.

Todd’s paralysis is mostly seen affecting one side of the body at a time. It can sometimes mimic stroke but it only occurs after a seizure. It is seen occurring in parts of the body affected by seizures. Todd’s paralysis or Todd’s paresis can also affect the sight leading to blurred vision or flashing of colors and speech making the person unable to speak or have a slurred speech.

What is Todd’s Paralysis?

Causes and Risk Factors of Todd’s Paralysis

The reason for the occurrence of Todd’s paralysis is not known, but it always occurs after epilepsy.

Researchers believe it to occur due to disruption to the processes of the brain slowing down the brain activity.(2) The motor center of the brain tends to get affected. These centers send signals to the body to move.

In rare cases, head injury leads to Todd’s paralysis. It is then mistaken to be a symptom of brain injury and treated accordingly.

A seizure can act as a trigger for Todd’s paralysis. It is known to occur in 6 percent of epileptic seizure cases.(3) A study showed that Todd’s paralysis lasted longer in people who went unconscious after a seizure.(4)

Also,Todd’s paralysis does not affect everyone with epilepsy and if some has had Todd’s paralysis once after an epileptic seizure it is not necessary that he will suffer from it again.

Symptoms of Todd’s Paralysis

There are different stages of epileptic seizures:

  • Aura or the warning stage
  • Ictal phase in which the seizure occurs
  • Postictal phase or the recovery phase.
  • Todd’s paralysis occurs in the recovery phase. This is why it is also sometimes known as postictal paralysis.
  • In the recovery stage, people feel tired, dizzy, and confused.

Todd’s paralysis occurs in 13% of the cases of epileptic seizures and can last from 30 minutes to 36 hours.(1, 2) After this, the person may feel completely normal.

How is Todd’s Paralysis Different From Stroke?

Todd’s paralysis usually affects one side of the body and can lead to slurred speech, weakness, and loss of sensations. The same symptoms occur during a stroke. But, these are two different issues that need to be addressed differently.

A person having a stroke needs emergency medical help as medications are needed to restore the flow of blood to the brain. A person takes time to recover from a stroke and many would need rehabilitation.

On the other hand, Todd’s paralysis goes away in a shorter time and has no lasting impact.

Unless it is clear that the paralysis follows a seizure, it would be difficult to differentiate whether a person is suffering from a stroke or Todd’s paralysis.

Diagnosis of Todd’s Paralysis

If someone experiences a seizure for the first time, a doctor should be seen. Seizures can happen for many reasons and epilepsy is not the only cause.

Tests are performed to look for the electrical activity of the brain and look for damage. Also, if a person with epilepsy has Todd’s paralysis, medical attention should be received.

Treatment of Todd’s Paralysis

Currently, there is no specific treatment for Todd’s paralysis. Managing epilepsy can help in managing the occurrence of seizures and thereby reduce paralysis.

Medications are given to change the levels of the chemicals in the brain that help in controlling seizures.(5) Also, avoiding triggers such as tiredness, flickering light, or stress, can help in preventing seizures.

A person with epilepsy is able to tell when they are about to have a seizure. It is a warning or aura. It includes:

  • Unusual smell or taste
  • An intense feeling of fear or delight
  • Unsettled feeling in the stomach
  • At this time they should get into a position so that they do not hurt themselves.

If Todd’s paralysis occurs after a seizure, a person should rest in a comfortable position and take medical attention if needed.

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:November 15, 2023

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