What is Todd's paralysis (Todd's palsy)?

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Last updated: April 3, 2025View editorial policy

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From the Guidelines

Todd Syndrome, also known as Todd's paralysis, is a neurological condition characterized by a temporary weakness or paralysis of a part of the body following a seizure, which can be mistaken for a stroke. This condition is often seen in patients who have experienced a seizure, particularly those with a history of epilepsy [ 1 ]. The symptoms of Todd Syndrome can be similar to those of a stroke, making it challenging to differentiate between the two conditions based on clinical examination and brain CT scan alone.

Key Characteristics

  • Temporary weakness or paralysis of a part of the body
  • Often occurs after a seizure
  • Can be mistaken for a stroke
  • Symptoms typically resolve within 24-48 hours

Diagnosis and Management

Diagnosing Todd Syndrome can be difficult, as it requires distinguishing it from other conditions such as stroke. Advanced imaging techniques like magnetic resonance diffusion and perfusion-weighted images, angiography, perfusion CT, or CT angiography can be helpful in making an accurate diagnosis [ 1 ]. Management of Todd Syndrome focuses on treating the underlying cause of the seizure and providing supportive care to manage symptoms.

Important Considerations

  • Todd Syndrome is a temporary condition, and symptoms usually resolve on their own within a short period
  • It is essential to differentiate Todd Syndrome from stroke, as the treatment approaches for these conditions are different
  • Advanced imaging techniques can be useful in making an accurate diagnosis and guiding management [ 1 ]

From the Research

Definition and Characteristics of Todd Syndrome

  • Todd syndrome, also known as Todd's paralysis, is a neurological abnormality characterized by temporary limb weakness or hemiplegia, typically occurring following a seizure, without enduring consequences 2.
  • The condition is often difficult to diagnose in individuals experiencing an acute ischemic stroke if they do not have a pre-existing history of epilepsy.

Clinical Manifestations and Diagnosis

  • Todd's paralysis is commonly observed after partial seizures or generalized tonic-clonic seizures 2.
  • The incidence of Todd's paralysis is greater if the epilepsy is associated with old age or stroke history 2.
  • The duration of Todd's paralysis can range from minutes to days, depending on the type of seizure or whether the patient has experienced cortical structural damage 2.
  • The etiology of Todd's paralysis is associated with cerebral perfusion abnormality after seizures 2.

Distinction from Other Conditions

  • Factors that may help clinicians distinguish Todd's paralysis from other clinical indications include the type of seizure, patient's age, and history of stroke 2.
  • Further research is needed to explore factors that distinguish Todd's paralysis from other indications that may lead to limb weakness in order to improve the diagnosis of Todd's paralysis 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Frequency and Pathophysiology of Post-Seizure Todd's Paralysis.

Medical science monitor : international medical journal of experimental and clinical research, 2020

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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