While the sympathetic nervous system feeds into the heart from both sides, often only the left sided nerves are targeted during sympathectomy, although destruction of the nerves on both sides may be required. Through this process, sympathectomy is effective at decreasing, but not abolishing, the risk of further life-threatening arrhythmias. Implantable cardioverter-defibrillator
While medication and sympathectomy aim to prevent abnormal heart rhythms from occurring in the first place, an implantable defibrillator (ICD) may be used to treat arrhythmias that medication has failed to prevent and restore a normal heart rhythm. These devices, usually implanted under the skin at the front of the chest below the shoulder, can continuously monitor the heart for abnormal heart rhythms. If a life-threatening arrhythmia is detected, the device can deliver a small electric shock to terminate the abnormal rhythm and restart the heart.Implantable defibrillators are often recommended for those with CPVT who have experienced blackouts, ventricular arrhythmias or cardiac arrest despite taking appropriate medication. These devices are life-saving, as it has been shown that their use confers a significant survival benefit in patients with CPVT. It has been suggested that the resulting surge of adrenaline caused by the pain of an electric shock from the device could theoretically bring on a cycle of recurrent arrhythmias and shocks known as an electrical storm, and therefore it is strongly recommended that those with an ICD implanted for CPVT take a beta blocker to dampen the effects of adrenaline.
Causes
The cause of Todds paresis has been attributed to the affected cortex being ‘exhausted’ or silenced due to increased inhibition, but these conjectures are not supported. It has been observed that the impairments that follow seizures are similar to those that follow strokes, where for a period of time blood flow to certain areas of the brain is restricted and these areas are starved of oxygen. Diagnosis
The most significant issue regarding the Todds paresis is its differentiation from a stroke. The issue is further complicated by the fact that some strokes trigger a focal seizure during the acute phase. A Todds paresis in this context may overestimate the extent of neurological deficit due to the vascular process itself resulting in erroneous decisions with regards to acute stroke therapy  such as thrombolysis. For this reason a seizure during an acute stroke is generally accepted to be a relative contraindication to thrombolytic therapy, especially in the absence of documented cerebrovascular occlusion using vascular imaging techniques.An infant with Todds paresis does not necessarily preclude the diagnosis of a febrile convulsion. This view is as a result of a recent study that showed the incidence of Todds paresis to be in 0.4% of infants that have been diagnosed with a febrile convulsion. Treatment
There is no treatment for Todds paralysis. Individuals must rest as comfortably as possible until the paralysis disappears. Prognosis
An occurrence of Todds paralysis indicates that a seizure has occurred. The prognosis for the patient depends upon the effects of the seizure, not the occurrence of the paralysis.