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When to Treat Seizures
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
The occurrence of a prior febrile seizure was associated with an increased risk for recurrence in the two prospective studies discussed above, but has not been a consistent risk factor. Seizure type (increased risk with partial seizures) has been important in studies of children but not consistently so in studies of adults. It is possible that in this regard children are different. A sibling history of epilepsy is a predictor in the two prospective studies discussed and of borderline significance in the study of Hopkins. Todd’s paralysis and status epilepticus have been examined in only two studies, and results are conflicting.
Seizures
Published in Lauren A. Plante, Expecting Trouble, 2018
The postictal state is a period of transition back to normal awareness and function lasting several minutes to hours or even days. Confusion, decreased alertness, and focal neurological deficits are typical and should gradually improve. Weakness, called postictal paresis or Todd’s paralysis, is present in approximately 13.4% of patients and may last hours to days (37). Other postictal symptoms may include transient aphasia, amaurosis, hemi anopsia, sensory loss, psychosis, and aggression. Hospitalization is not necessary if the neurological exam is normal and mental status has returned to baseline. Nonetheless, admission is common in pregnant women with new-onset seizures.
Epilepsy
Published in Hani Ts Benamer, Essential Revision Notes in Clinical Neurology, 2017
➤ Frontal lobe epilepsy represents 30% of partial-onset seizures and usually presents initially with deviation of the head and eyes to one side, and is associated with jerking of the arm on the same side. This may be followed by paralysis of the arm (Todd’s paralysis). It can also cause complex or bizarre automatisms.
A modified Essen Stroke Risk Score for predicting recurrent ischemic stroke at one year
Published in Neurological Research, 2018
Xia Ling, Shuang-Mei Yan, Bo Shen, Xu Yang
This study was approved by the Local Ethics Association and the Hospital Ethics Committee. This is a prospective cohort study. Eight hundred and seven patients with acute ischemic stroke admitted in our hospital from December 2012 to June 2014 were included in this study. Patients enrolled were aged ≥18 years and fulfilled the following four criteria: (1) The diagnosis of acute ischemic stroke was determined in accordance with World Health Organization criteria [20]; (2) Their diagnosis were verified by CT or MRI (ischemic stroke or TIA); (3) Their symptoms reflected the infarct area; (4) Within 14 days after the onset; (5) Signed the consent informed form. The Exclusion Criteria include (1) transient ischemic attack and hemorrhagic stroke; (2) silent (asymptomatic) cerebral infarction without symptoms and signs; (3) Patients with noncerebrovascular diseases such as primary brain tumors, brain metastases, subdural hemorrhage, Todd paralysis, brain trauma, etc; (4) those who refused to sign the consent informed form of the study.
An interesting case of functional visual loss presenting as a left homonymous hemianopia
Published in Clinical and Experimental Optometry, 2021
The differential diagnosis for a homonymous hemianopia with a normal magnetic resonance imaging and electroencephalogram is quite limited.7 Organic conditions to consider include hypoxic brain injury, Heidenhain variant Creutzfeldt–Jakob disease, posterior reversible encephalopathy, and posterior cortical atrophy.7 In all of these cases, the magnetic resonance imaging is abnormal but may be misinterpreted. Post-migraine and post-ictal (Todd’s paralysis) cases are usually transient. The other possibility is non-organic or functional visual loss.
Stroke mimics: incidence, aetiology, clinical features and treatment
Published in Annals of Medicine, 2021
Brian H. Buck, Naveed Akhtar, Anas Alrohimi, Khurshid Khan, Ashfaq Shuaib
The clinical presentation poses no problems with intracranial mass lesions. Occasionally, low-grade gliomas can present with focal seizures and post-ictal Todd’s paralysis. The brain tumour on imaging may be confused for an ischaemic stroke. Typically, the lesion on CT and MRI do not correspond to vascular distribution and may have surrounding oedema.