Department of Neurology, Friedrich-Schiller-University, Erlanger Allee 101, D-07747 Jena, Germany.
Epilepsy Res. 2010 May;89(2-3):355-9. doi: 10.1016/j.eplepsyres.2010.02.009. Epub 2010 Mar 16.
The clinical differentiation between stroke and seizure is usually straightforward but postictal neurological deficits can be mistaken for stroke in case no detailed medical history is available. Up to now, the imaging findings of Todd's paresis are not well described. This case report demonstrates that postictal paresis can be accompanied by a reversible global hemispheric hypoperfusion as measured with perfusion MRI indicating transient but profound cerebrovascular dysfunction in postictal paresis. Extensive postictal perfusion changes must be discriminated from emerging stroke to avoid potentially harmful therapy like thrombolysis. Further investigations are warranted to clarify the role of cerebrovascular dysfunction in the pathophysiology of postictal paresis.
中风和癫痫发作的临床鉴别通常很直接，但如果没有详细的病史，发作后的神经功能缺损可能会被误诊为中风。到目前为止，Todd 麻痹的影像学表现还没有很好地描述。本病例报告表明，发作后瘫痪可伴有灌注 MRI 测量的可逆性半球全脑低灌注，提示发作后瘫痪存在短暂但严重的脑血管功能障碍。必须将广泛的发作后灌注变化与新发中风区分开来，以避免溶栓等潜在有害治疗。需要进一步研究来阐明脑血管功能障碍在发作后瘫痪病理生理学中的作用。
