What is Todd's palsy and what causes it?

Paralysis is not uncommon in life. For example, if you sleep on the table and wake up, you will feel numbness in your hands and feet. So what is Todd palsy? What causes Todd's palsy?

Todd is paralyzed

The disease was first described by London physiologist Robert Bentley Todd in 1849 and is named after him. Todd's palsy is a neurological disorder that occurs in people with epilepsy, resulting in temporary paralysis during a seizure. The paralysis can be partial or whole body, but usually occurs on only one side of the body. It most commonly follows a generalized tonic-clonic seizure (grand mal seizure) and may last for hours or occasionally days after the seizure is over.

Causes

The cause is unknown, but there are two hypotheses. One is the depletion theory, in which depletion of the motor cortex results in prolonged hyperpolarization of neurons. The second is the transient inactivation of motor fibers caused by NMDA receptor activation. Because the paralysis disappears quickly, treatment is symptomatic and supportive. The prognosis of this disease is related to the degree of epilepsy.

Differential Diagnosis

The most significant significance of this disease is the differential diagnosis from stroke. In the acute phase, some strokes can trigger focal epileptic seizures. If Todd's paralysis occurs in this context, the patient's neurological condition may be overestimated, leading to incorrect medical measures such as thrombolytic therapy. For this reason, thrombolytic therapy is generally considered a relative contraindication to epileptic seizures in the acute phase of stroke, especially in the absence of evidence of cerebrovascular infarction before vascular imaging. Thrombolytic therapy is contraindicated in cases where the diagnosis is not clear. It is recommended to first adopt anti-epileptic, anticoagulant, vasodilation, brain cell nutrition, free radical scavenging, acupuncture and other measures. At the same time, further examinations should be performed as soon as possible. For example, diffusion-weighted imaging (DWI) in CT and MRI is of great value in the diagnosis of cerebral ischemic stroke.