Bilateral Todd’s paralysis after status epilepticus

Razan Hussein BS, Cameron Miller BS, Edwin J. Paul MPH, Ben Thiravetyan MD, J Drew Payne, DO

ABSTRACT

Todd’s paralysis is a transient postictal neurologic deficit most often presenting as unilateral weakness that resolves within 48 hours. Bilateral involvement is exceedingly rare and can closely mimic acute spinal cord or neuromuscular pathology. This Clinician’s Corner case describes a young woman who developed acute bilateral lower-extremity weakness following status epilepticus, with complete spontaneous recovery within 32 hours. The case highlights key diagnostic features of bilateral Todd’s paralysis and emphasizes a practical, clinically oriented approach to evaluation and management.

Keywords: Todd’s paralysis, Status Epilepticus, Postictal paralysis, Epilepsy, Neurologic deficits


Article citation: Hussein R, Miller C, Paul EJ, Thiravetyan B, Payne JD. Bilateral Todd’s paralysis after status epilepticus. The Southwest Journal of Medicine. 2026;14(60):87-89
From: Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX (RH, CM, EJP, BT, JDP)
Conflicts of interest: none
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