Binder Devin K
Department of Neurological Surgery, M779 Moffitt Hospital, Box 0112, University of California-San Francisco, San Francisco, CA 94143-0112, USA.
Neurosurgery. 2004 Feb;54(2):480-6; discussion 486-7. doi: 10.1227/01.neu.0000103490.49537.37.
To describe the history of Robert Bentley Todd (1809-1860) and certain of his contributions to medicine, including his original and subsequent descriptions of "epileptic hemiplegia," which came to be called "Todd's paralysis."
The author conducted a comprehensive review of English-language literature, modern and historical, related to "Todd's paralysis" and examined Todd's original case histories and commentary by Todd, his contemporaries, and his successors.
Todd held that some patients "who recover from a severe fit, or from frequently repeated fits of epilepsy, are often found to labor under hemiplegia, or other modifications of palsy." He believed that this resulted from "undue exaltation. [resulting in] a state of depression or exhaustion." Interestingly, Todd was the first to present an electrical theory of epilepsy, supported by his own animal experimentation, well before his better-known successor John Hughlings Jackson (1835-1911) (famous for his investigations of partial epilepsies and the eponymous "Jacksonian march").
Many neurologists and investigators followed Todd in acknowledging transient postictal paralysis as a distinct clinical entity. Yet whether the pathophysiology of "Todd's paralysis" is related to "neuronal exhaustion" or excessive inhibition is still controversial.
描述罗伯特·本特利·托德（1809 - 1860）的生平及其对医学的某些贡献，包括他最初及后续对“癫痫性偏瘫”的描述，该病症后来被称为“托德麻痹”。
作者对与“托德麻痹”相关的现代及历史英文文献进行了全面综述，并研究了托德的原始病例记录以及托德本人、其同时代人及后继者的评论。
托德认为，一些“从严重癫痫发作或频繁反复发作中恢复过来的患者，常常会出现偏瘫或其他形式的麻痹”。他认为这是由“过度兴奋[导致]抑郁或衰竭状态”所致。有趣的是，早在其更为著名的后继者约翰·休林斯·杰克逊（1835 - 1911）（以对部分癫痫的研究及同名的“杰克逊癫痫发作扩展”而闻名）之前，托德就通过自己的动物实验首次提出了癫痫的电学理论。
许多神经学家和研究者追随托德，将发作后短暂性麻痹视为一种独特的临床实体。然而，“托德麻痹”的病理生理学是与“神经元衰竭”还是过度抑制相关，仍存在争议。
