Xu Sui-Yi, Li Ze-Xing, Wu Xiao-Wei, Li Ling, Li Chang-Xin
Department of Neurology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China (mainland).
Department of Neurology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China (mainland).
Med Sci Monit. 2020 Mar 5;26:e920751. doi: 10.12659/MSM.920751.
Todd's paralysis, a neurological abnormality characterized by temporary limb weakness or hemiplegia, typically occurs following a seizure, without enduring consequences. Since limb weakness or hemiplegia can also be a common symptom of an acute ischemic stroke, it is often difficult to diagnose Todd's paralysis in individuals experiencing an acute ischemic stroke if they do not have a pre-existing history of epilepsy. Given that there is a limited understanding of Todd's paralysis, this review discusses the history, prevalence, clinical manifestations, duration, etiology, and diagnosis of Todd's paralysis. A few factors that may help clinicians distinguish Todd's paralysis from other clinical indications are as follows: (1) 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. (3) 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. (4) The etiology of Todd's paralysis is associated with cerebral perfusion abnormality after seizures. 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.
托德麻痹是一种以肢体短暂无力或偏瘫为特征的神经异常,通常在癫痫发作后出现,不会产生持久后果。由于肢体无力或偏瘫也可能是急性缺血性中风的常见症状,对于没有癫痫病史的急性缺血性中风患者,往往很难诊断出托德麻痹。鉴于对托德麻痹的了解有限,本综述讨论了托德麻痹的病史、患病率、临床表现、持续时间、病因及诊断。一些可能有助于临床医生将托德麻痹与其他临床指征区分开来的因素如下:(1)托德麻痹常见于部分性发作或全身强直阵挛性发作之后。(2)如果癫痫与老年或中风病史相关,托德麻痹的发生率更高。(3)托德麻痹的持续时间从数分钟到数天不等,这取决于发作类型或患者是否经历过皮质结构损伤。(4)托德麻痹的病因与癫痫发作后的脑灌注异常有关。需要进一步研究以探索区分托德麻痹与其他可能导致肢体无力的指征的因素,以改善托德麻痹的诊断。