Todd's palsy is a type of neurological disorder associated with the occurrence of areas of excitation in the brain. It can last from several minutes to days. To make this diagnosis, it is necessary to exclude all other similar pathologies, including organic damage to the nervous system.
Definition
Todd's palsy is a transient condition that develops after an epileptic seizure. Patients have paresis or paralysis of the limbs both on one side and on both sides. Such paralysis is the first warning of nervous system exhaustion and may be a symptom of cancer or metabolic disorders.
Paralysis can be diagnosed only after magnetic resonance imaging, which will rule out cerebrovascular accident and organic damage to the nervous tissue. Additionally, the doctor may prescribe electroencephalography (EEG) to detect foci of epilepsy, dopplerography of cerebral vessels, angiography and other tests.
If the cause of the seizures is notfound, the treatment is reduced to the relief of epilepsy.
Reasons
Todd's paralysis is still one of the medical mysteries. And without knowing the cause, doctors cannot develop a mechanism for uncoupling the pathological process in order to cure it. Based on circumstantial evidence, doctors have several assumptions regarding the nature of the disease. According to the most progressive theory, the “phenomenon of inhibition of the nervous system” manifests itself in the form of paralysis. It is associated with impaired transmission of neurotransmitters.
Besides this, there are several more reasons:
- several epileptic seizures in a row;
- brain exhaustion;
- malignant neoplasm of the central nervous system;
- inflammation of the brain substance, especially of viral etiology;
- dissociation of lipid metabolism;
- the presence of ischemic strokes in the past;- diseases of the heart and blood vessels.
Symptoms
What is the manifestation of Todd's paralysis? Symptoms initially resemble those of an epileptic seizure. For others, watching an attack can be quite difficult, since they have no way to help the patient. But even after the convulsions end, the person cannot fall asleep and get a happy oblivion. On the contrary, he freezes and cannot move his arms and legs.
How long does Todd's paralysis last? Symptoms (photographs of patients can be traumatic and considered unethical) sometimes persist around the meshes or more. Doctors most often note the appearance of unilateral paralysis or paresis. Over time, motor blockadepasses without leaving any consequences. In medical periodicals, cases of Todd's paralysis with visual and articulation disorders were recorded.
At the first encounter with this pathology, the symptoms can be regarded as manifestations of a stroke, but after all the necessary diagnostic measures have been taken, the primary diagnosis is removed, and the rapid regression of symptoms confirms the version of paralysis.
Diagnosis
What do you need to do to confirm Todd's paralysis? The signs of the disease are rather vague. It is necessary to exclude all other pathologies in order to be sure of the diagnosis. First of all, the severity of the observed condition and the level of muscle paralysis should be determined. For this, a physical examination is carried out and the data obtained are compared with a five-point scale:
- Five points is the complete absence of symptoms, the patient's muscles are in a state of physiological norm.
- Four points - strength indicators are slightly reduced, but the activity of the limbs is still preserved. The patient calmly overcomes the resistance of the doctor's hand.
- Three points - the victim's muscles are visible to the naked eye, but the patient is still able to make voluntary movements, although not as quickly as at four points. It becomes more difficult to overcome the resistance of the doctor's hand.
- Two points - Earth's gravity becomes an insurmountable barrier for such a patient.
- One point - there is complete paralysis of the muscles.
After the examination, the doctor collects a thoroughanamnesis from the patient's relatives, studies the medical record, prescribes a computer or magnetic resonance imaging. To rule out a stroke, the patient undergoes angiography to identify the focus of epilepsy (if there is one in the anamnesis), electroencephalography is prescribed. To determine concomitant pathologies, an ultrasound examination of the heart and electrocardiography are done.
Only having all the results, the doctor can choose the most probable one among all the possible diagnoses and start therapy.
Treatment
How can you stop Todd's paralysis? Treatment, although purely symptomatic, is not very effective, since it is difficult to accurately determine the cause of such a condition. Therapy depends on the level and severity of paralysis.
If movement disorders are minor, no specific treatment is required. Symptoms will go away on their own in a few hours or days. For deeper disorders, benzodiazepine drugs such as Midazolam, Diazepam, Lorazepam, Phosphenytoin or Phenytoin are used. Each of them stops convulsive attacks, their consequences. When prescribing them, it must be remembered that abrupt withdrawal of antiepileptic drugs can also provoke an attack.
There are contraindications for prescribing these drugs. First of all, of course, this is intolerance to the components of the drug, as well as a history of angle-closure glaucoma and drug or alcohol addiction. In addition, kidney function plays an important role, as the drug is mainly excreted in the urine.
Prevention
Todd's post-seizure palsy cannot be prevented. This condition has not yet been fully studied, therefore, specific prevention, as well as treatment, cannot be developed. Perhaps some time later, when the possibilities of medicine become even greater, we will be able to take some steps to eliminate this pathology.
Today, doctors give very vague advice, such as maintaining a he althy lifestyle, proper nutrition, avoiding bad habits and moderate physical activity. In addition, do not forget about periodic preventive examinations, because any disease is easier to prevent than to treat.
Forecast
Todd's palsy can have both a favorable and unfavorable prognosis. It all depends on the severity of neurological symptoms and the duration of paresis or paralysis. If a neuropathologist gives a rating of “three” or “four” on a five-point scale, then in this case the disease does not cause significant concern, and the prognosis for life and he alth is favorable. The body recovers quickly after attacks, the condition does not require medical intervention.
If the paralysis lasts for a long time, the functions of the limbs are restored for a long time, and the number of attacks becomes more frequent over time, then the prognosis for life, of course, is unfavorable.
Newestresearch
Todd's right- and left-sided palsy can progress, and over time, muscle weakness remains even after long-term treatment. For these patients, as well as other paralyzed people, science has a couple of revolutionary ideas to offer. The first of these is to create prostheses. To date, there are prototypes of bionic limbs controlled by the power of thought, that is, the device connects to the nervous system and perceives nerve impulses, decoding signals.
The second method is more biological. It is based on the restoration of nerve endings using stem cells. Since they have a tendency to almost endless division, and can also differentiate into any cell in the human body. So far, experiments are being carried out on laboratory animals, but if they are successful, it will be possible to hope for a significant breakthrough in the treatment of neurological diseases.
