Todd Paralysis in a Pregnant Mother Presenting as Acute Stroke: Case Report

Abstract

Beria Aksu Selman,1,* Mohamed Sheikh Hassan,2,3,* Rahim Rahimov,1 Saltanat Mert,1 Ayhan Köksal1 1University of Health Science, Neurology Department Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey; 2Department of Neurology, Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia; 3Faculty of Medicine and Surgery, Mogadishu University, Mogadishu, Somalia*These authors contributed equally to this workCorrespondence: Mohamed Sheikh Hassan, Department of Neurology Mogadishu Somalia Turkish Training and Research Hospital, Mogadishu, Somalia, Email [email protected]: Todd’s paralysis (TP) is relatively uncommon condition that can occur immediately after an epileptic seizure. It is a heterogeneous clinical syndrome that presents with acute-onset neurological findings, such as paralysis, paresthesia, aphasia, hemianopsia, and an altered state of consciousness. This may be accompanied by cytotoxic edema on diffusion MRI. This case illustrates a 28-week pregnant patient with TP who presented with acute stroke-like clinical and radiological findings. The patient was presented to the emergency room with left side weakness following focal onset generalized seizure. Magnetic resonance imaging demonstrated diffusion restriction which led to the initial consideration of acute stroke. However, after the disappearance of the neurologic deficit and the resolution of the diffusion restriction in the control MRI, the diagnosis shifted away from acute stroke to the postictal TP. It is important to keep in mind that TP may mimic acute stroke even in the presence of an acute brain lesion in the brain MRI. The differentiation is necessary as each of them has completely different treatment and etiology.Keywords: Todd paralysis, acute stroke, magnetic resonance imaging, hemiplegia

Keywords

• todd paralysis
• acute stroke
• magnetic resonance imaging
• hemiplegia