Todd's Paralysis

[Bee91]

I went to my doctor a couple of days ago. I had a seizure while I was in the waiting room. My doctor came out in the waiting room and saw me trying to walk. I couldn't walk because my right leg was turned in and very weak. It is turned pigeon toed and I am practically walking on my ankle with my knee completely bent. It lasts anywhere from 20 minutes to an hour and a half. It only happens after my bigger seizures and we have told every single one of my neurologists about what my right leg does yet everydoctor has failed to say anything about Todd's Paralysis. I don't know how significant it is, but I was wondering if it is a clear cut sign of Epilepsy.
I have had the problem with my leg since the begining of my seizures. Never before. I am irritated that no other doctor said anything. How significant is this? And can you diagnose your type of seizures/ a seizure disorder by Todd's Paralysis?

[Bernard]

I'm not finding much useful information about Todd's Paralysis on the net. Just about every site I find has copied the info on the NINDS's page ("Treatment of Todd's paralysis is symptomatic and supportive because the paralysis disappears quickly.").

However, I did find this:

The most significant issue regarding the Todd's paresis is its differentiation from a stroke. The issue is further complicated by the fact that some strokes trigger a focal seizure during the acute phase. A Todd's paresis in this context may overestimate the extent of neurological deficit due to the vascular process itself resulting in erroneous decisions with regards to acute stroke therapy such as thrombolysis. For this reason a seizure during an acute stroke is generally accepted to be a relative contraindication to thrombolytic therapy, especially in the absence of documented cerebrovascular occlusion using vascular imaging techniques.[6]

Todd's paresis

[brain]

Brandi:

Todd's Paresis - Todd's Paralysis is a post-itcal
stage, it only happens after a seizure. I've had
it multiple times, most of the time it's pretty
mild and goes away, but I've had several severe
hits where it would take nearly a week to recover
from it.

It's just plain too scary. Sufficient enough that one
had a seizure, worse that when a Todd's follows
afterwards and you're paralyzed!

Below is one example:

Epilepsy Foundation - Heroes / Southie's Page

Todd's Paresis aka Todd's Paralysis - from Wiki

Todd's paresis, as defined as any motor deficit after seizure, occurs in 13% of all seizures.[2] This was evaluated in a study of 513 patients with epilepsy with video-electroencephalography. The same study also showed that the mean duration of postictal paresis was 173 seconds, with ranges of 11 seconds to 22 minutes.[2] There have been case reports of longer durations of paresis, ranging to as long as days.[3]

Other post-ictal neurological findings that do not involve activity of the area affected by the seizure have been described. They are thought to be caused by a different mechanism than Todd's paresis, and including paralysis of the contralateral limb,[4] and rare genetic causes of hemiplegia and seizures.[5]

Todd's paresis is more common after any clonic seizure activity, and particularly if generalized tonic-clonic seizures occur.[2]

Todd's Paralysis - from NINDS

What is Todd's Paralysis?

Todd's paralysis is a neurological condition characterized by a brief period of transient (temporary) paralysis following a seizure. The paralysis - which may be partial or complete - generally occurs on one side of the body and usually subsides completely within 48 hours. Todd's paralysis may also affect speech or vision. The cause is not known. Examination of an individual who is experiencing or who has just experienced Todd's paralysis may help physicians identify the origin of the seizure. It is important to distinguish the condition from a stroke, which requires different treatment.

Is there any treatment?

Treatment of Todd's paralysis is symptomatic and supportive because the paralysis disappears quickly.

What is the prognosis?

An occurrence of Todd's paralysis indicates that a seizure has occurred. The prognosis for the patient depends upon the effects of the seizure, not the occurrence of the paralysis.

[brain]

Bernard and I posted at the same time!