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.
Velopharyngeal incompetency occurs when the soft palate and the lateral/posterior pharyngeal walls fail to separate the oral cavity from the nasal cavity during speech. Although the definitions are similar, the etiologies correlated with each term differ slightly. However, in the field of medical professionals these terms are typically used interchangeably. References
Conley SF, Gosain AK, Marks SM, Larson DL (1997). "Identification and assessment of velopharyngeal inadequacy". Am J Otolaryngol. 18 (1): 38–46. doi:10.1016/S0196-0709(97)90047-8. PMID 9006676. Johns DF, Rohrich RJ, Awada M (2003). "Velopharyngeal incompetence: a guide for clinical evaluation". Plast. Reconstr. Surg. 112 (7): 1890–7, quiz 1898, 1982. doi:10.1097/01.PRS.0000091245.32905.D5. PMID 14663236. McWilliams, Betty Jane; Peterson-Falzone, Sally J.; Hardin-Jones, Mary A.; Karnell, Michael P. (2001). Cleft palate speech. St. Louis: Mosby. ISBN 0-8151-3153-4. Hardin-Jones, Mary A.; Peterson-Falzone, Sally J.; Judith Trost-Cardamone; Karnell, Michael P. (2005). The Clinicians Guide to Treating Cleft Palate Speech. St. Louis: Mosby-Year Book. ISBN 0-323-02526-9. Willging JP (1999). "Velopharyngeal insufficiency". Int. J. Pediatr. Otorhinolaryngol. 49 Suppl 1: S307–9. doi:10.1016/S0165-5876(99)00182-2. PMID 10577827. == External links ==