Todd's Paralysis: A Cerebrovascular Phenomenon?

Postictal transient focal neurological deficits, i.e., Todd's paralysis, at times are correlated with early veins and/or vascular stain angiographically. Radionuclide gamma camera images show that they also may be accompanied by a relative flow hyperperfusion and a cortical rim static image uptake. Using these observations some portion of Todd's paralysis may be explained as the result of focal epileptic discharges that lead to local vasomotor and/or metabolic changes. The functional arterial venous shunting that results could contribute to cortical ischemia and the subsequent clinical deficits.