What is Todd's

paralysis?
By Claire Sissons | Last reviewed Sun 17 Dec 2017

Reviewed by Debra Rose Wilson, PhD, MSN, RN, IBCLC,

AHN-BC, CHT

Table of contents

Todd's paralysis is experienced by

some people with epilepsy. It
happens after a seizure when it
becomes impossible to move all or
part of the body.

Epilepsy is a condition that causes electrical

activity in the brain that can stop it working for
a short time. The result is what is known as a
seizure, convulsion, or fit.
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There is no clear cause of Todd's paralysis.

Depending on the part of the brain that is
affected, symptoms can include temporary
problems with sight or speech, as well as loss
of movement.

In rare cases, Todd's paralysis affects people

who do not have epilepsy, such as those who
have had a head injury.

In this article, we find out more about the

condition, its symptoms, and what might
cause it.

What is Todd's
paralysis?

Todd's paralysis commonly affects one hand, arm, or leg, but it

may also affect the whole body.

Todd's paralysis is also referred to as Todd's

paresis, Todd's palsy, or postictal paresis. It is
a neurological condition, meaning it relates to
the brain and nerves.

Different parts of a person's brain control

different processes and activities in their
body, such as speech or movement.

Most people who experience Todd's paralysis

have epilepsy, and symptoms occur
immediately after a seizure. The brain takes
time to recover from a seizure, and this can
have an impact on the body.

Todd's paralysis commonly affects one hand,

arm, or leg, but the condition can affect the
whole body. The effects can range from a
weakness in one part of the body to a full loss
of movement and sensation.

The condition can affect sight and speech. A

person experiencing Todd's paralysis may be
unable to speak, or have slurred speech. They
may be unable to see, experience blurred
vision, or see flashing lights or colors.

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Symptoms
Epileptic seizures have different stages:

1. An aura or warning, although all who

have epilepsy will not experience this.

2. The seizure itself, which is known as the

ictal phase.

3. Recovery from the seizure, known as

the postictal phase.

Todd's paralysis happens during the recovery

phase, which is why it is sometimes known as
postictal paralysis.

Some people will feel back to normal

immediately after an epileptic seizure, while
for others it can take minutes or hours to
recover.

During the recovery time from a seizure, it is

common for a person with epilepsy to have
symptoms that can include confusion,
tiredness, or dizziness.

Todd's paralysis is a less common experience

after a seizure. Depending on which part of
the brain is recovering, different parts of the
body will be affected by paralysis.

A person experiencing Todd's paralysis will be

unable to move part or all of their body. The
condition usually only happens on one side of
the body so can be confused with a stroke.

Paralysis can last between 30 minutes and 36

hours, after which feeling and movement will
return completely. The average time for
paralysis to last is 15 hours.

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Differences from stroke

Todd's paralysis usually only affects one side

of the body, causing weakness or a loss of
sensation, and can make speech slurred.
Stroke shares all these symptoms.
Consequently, Todd's paralysis can be easily
confused with a stroke, but it needs different
treatment.

Stroke is a medical condition requiring

emergency care. Blood supply to the brain
needs to be restored, urgently, with
medication or surgery.

A stroke will take time to recover from, and

many people need rehabilitation. Their
rehabilitation may mean support to enable
them to resume normal life and be able to
speak, grip things, or walk again.

In contrast, Todd's paralysis will go away after

a relatively short time and usually has no
lasting impact. It is linked to epilepsy, a
condition that can be managed in most cases.

Causes and risk factors

Theories suggest that Todd's paralysis may be caused by the

motor centers of the brain slowing down.

It is not clear what causes Todd's paralysis.

Theories suggest that it may be due to

processes in the brain that slow down brain
activity. The areas of the brain that can be
particularly affected are the motor centers,
which are responsible for telling the body to
move.

In rare cases, Todd's paralysis may happen

after a head injury. It can be mistaken for a
symptom of the brain injury and treated
accordingly.

Not everyone who has epilepsy will

experience Todd's paralysis. No clear risk
factors have been found that mean certain
people will be more likely to have the
condition than others.

Because Todd's paralysis happens

immediately after a seizure, fewer seizures will
mean that paralysis also occurs less often. A
person can reduce the number of seizures
they have by ensuring their epilepsy is
managed with medication and self-care,
including getting enough sleep.

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Diagnosis
If someone has a seizure for the first time,
they should see a doctor, as soon as they can.
They may be referred to a brain and nerve
specialist known as a neurologist. It should be
remembered that there are many reasons for
seizures and epilepsy is not their only cause.

Epilepsy can be hard to diagnose, so

describing a seizure in detail can help. Tests
may be needed to check the brain for
electrical activity or any damage.

If a person has symptoms of Todd's paralysis

and has already been diagnosed with
epilepsy, they should seek medical advice.
The doctor or neurologist will ask questions
about what happens after a seizure, and may
check that medication is correct.

Treatment

A patient may be referred to a neurologist if they have a seizure

for the first time.

There are currently no treatments available for

Todd's paralysis. However, controlling a
person's seizures will reduce the number of
times they experience paralysis.

Treatment for epilepsy focuses on stopping or

reducing seizures. Medication that changes
the level of chemicals in the brain helps to
control seizures in around 70 percent of
people.

Some of those with epilepsy have clear

triggers for their seizures, such as a lack of
sleep or flickering lights, and can avoid these
to prevent seizures from happening.

Some people may be able to tell when they

are about to have a seizure. This awareness is
known as a warning or aura and can have a
range of symptoms, including:

an unusual smell or taste

an intense feeling of fear or delight

an unsettled feeling in the stomach

If a person with epilepsy feels they are about

to have a seizure, they should try to get into a
position where they cannot hurt themselves.
This might include lying on a floor away from
walls and furniture and loosening clothes that
are tight around the neck. These precautions
can help to avoid injuries and aid breathing if
a seizure occurs.

If Todd's paralysis happens after a seizure, a

person should rest in as comfortable a
position as possible until it goes away.

People should seek medical treatment the

first time they experience the condition and
ask the doctor what might happen with any
future seizures and paralysis.

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Outlook
Todd's paralysis is easily confused with a
stroke, but ends much more quickly and has
no lasting symptoms. It can be diagnosed if it
happens directly after a seizure.

A person with epilepsy who experiences

Todd's paralysis should rest while symptoms
pass.

It is often possible to reduce the number of

seizures someone has with the help of
medication, self-care, and by pinpointing
triggers, such as stress or tiredness.

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EPILEPSY NEUROLOGY / NEUROSCIENCE

Additional information

Article last reviewed by Sun 17 December 2017.

Visit our Epilepsy category page for the latest

news on this subject, or sign up to our
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Epilepsy.

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