Todd's paralysis following an interscalene block

Abstract

We describe a patient who experienced a focal seizure, probably secondary to the intravascular injection of bupivacaine. She then experienced a second seizure, possibly due to intrinsic cerebral scarring or tumor. Her recovery was accompanied by a profound hemiparesis. In our opinion, the etiology of her postictal hemiparesis (Todd's paralysis) was the combined effect of a right brachial plexus block, secondary to our interscalene injection, combined with a right lower extremity paresis.