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NON-EPILEPTIC ATTACK DISORDER AND TODD'S PARESIS: A CASE SERIES AND LITERATURE REVIEW
  1. J Singh*
  1. Humber NHS Trust

    Abstract

    Background Todd's paresis is a transient focal weakness of the hand, arm or leg which follows partial seizure activity within that limb. This was first described by Robert Bentley Todd in 1849. The weakness can range in severity from mild to complete paralysis and usually occurs on just one side of the body. The paralysis can last from minutes to hours. It may occur in up to 13% of seizure cases. Todd's paresis may affect speech, eye gaze or vision. It most commonly occurs after generalised tonic clonic seizures. Treatment of Todd's paralysis is symptomatic and supportive because it resolves quickly.

    Three of our patients with a diagnosis of Non-Epileptic Attack Disorder (NEAD) complained of motor weakness after the seizure. This led us to reinvestigate their cases to rule out epilepsy.

    The above three patients have a diagnosis of NEAD. Todd's Paresis has an association with true seizures rather than with NEAD. The subjective complaint of post seizure weakness made us interested in finding out if there is any association of motor weakness with NEAD

    We did an electronic literature search using PubMed, Medline and Trip Database.

    Discussion Our three patients above had a diagnosis of NEAD and they all complained of motor weakness or Todd's paresis, which is more characteristic of Epilepsy.

    We wanted to establish if there is any association between Todd's paresis and NEAD. We tried to find the answer by doing a literature search but unfortunately this was not helpful.

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