TODD’S PARESIS — TEMPORARY WEAKNESS AFTER A SEIZURE
A seizure can sometimes be followed by temporary weakness affecting part of the body.
This is known as Todd’s paresis.
It may affect:
one arm
one leg
the face
an arm and leg together
one entire side of the body
or, much less commonly, both sides.
The weakness develops after seizure activity has ended and gradually improves as the brain recovers.
Todd’s paresis is a recognised postictal neurological deficit. The International League Against Epilepsy’s seizure-semiology glossary describes it as occurring after focal motor seizures or focal-to-bilateral tonic–clonic seizures, with weakness usually lasting from minutes to hours.
It is particularly important because sudden weakness can also be caused by stroke.
A new episode of weakness should therefore never simply be assumed to be Todd’s paresis without considering the wider clinical situation.
Why is it called “Todd’s paresis”?
The phenomenon is named after the nineteenth-century physician Robert Bentley Todd, who described temporary paralysis following epileptic seizures.
You may also see the terms:
Todd’s paralysis
Todd paralysis
postictal paresis
postictal paralysis
postictal weakness
used in medical literature.
Technically:
paresis means weakness or reduced voluntary movement
while:
paralysis implies complete loss of voluntary movement.
Because the postictal deficit can range from mild weakness to complete inability to move a limb, Todd’s paresis is often the more accurate general term.
What actually happens?
After a seizure, voluntary movement in part of the body may temporarily become weaker than normal.
For example, someone may discover that:
one arm feels heavy
one hand cannot grip normally
one leg gives way
one side of the face droops
an arm cannot be lifted
walking is difficult
or an entire side of the body appears paralysed.
The pattern can vary considerably.
In a prospective study of 229 people following generalised tonic–clonic seizures, 14 developed Todd’s post-epileptic paralysis. The pattern ranged from mild weakness to complete paralysis and could involve different combinations of the face, arm and leg.
So Todd’s paresis does not have one single appearance.
It is a postictal symptom
Todd’s paresis begins after the seizure.
That distinction matters.
Weakness or inability to move that occurs during seizure activity can represent something different, including certain rare seizure manifestations involving so-called negative motor phenomena.
Todd’s paresis specifically refers to a temporary postictal deficit.
The person may simultaneously experience other postictal effects such as:
tiredness
confusion
headache
memory impairment
or language problems.
But weakness can also occur while the person otherwise appears relatively alert.
Related Information Hub page:
After the Seizure — Understanding the Postictal State
Which seizures can cause Todd’s paresis?
Todd’s paresis is most strongly associated with seizures involving motor brain networks.
ILAE semiology guidance notes that it can occur following:
focal motor seizures
and focal-to-bilateral tonic–clonic seizures.
It most often reflects seizure involvement of the motor cortex.
However, the seizure itself does not necessarily have to begin in the motor cortex.
Seizure activity originating elsewhere can spread into motor networks before it ends.
Postictal paresis has therefore also been documented in people whose seizures originate in:
temporal
parietal
occipital
and other brain regions.
How common is it?
Todd’s paresis is much less common than general postictal symptoms such as tiredness or confusion.
One frequently cited video-EEG study found postictal paresis in approximately 6% of focal-to-bilateral tonic–clonic seizures.
ILAE semiology guidance notes that this may underestimate its true occurrence because detailed motor testing is not always performed immediately after seizures.
A systematic review of postictal manifestations also demonstrates that motor deficits form only one part of a much wider range of post-seizure symptoms.
So most seizures do not produce Todd’s paresis.
Why does it usually affect the opposite side?
Movement on one side of the body is mainly controlled by the opposite cerebral hemisphere.
For example:
the left motor cortex predominantly controls movement on the right side of the body.
If a seizure significantly involves the motor networks of the left hemisphere, a postictal motor deficit may therefore appear on the right side.
This relationship gives Todd’s paresis potential lateralising value.
Todd’s paresis can give specialists information about seizure networks
A major 2026 systematic review examined the localising and lateralising value of postictal signs in focal epilepsy.
Across the studies included in the review, postictal paresis occurred contralateral to the epileptic focus and was more strongly associated with frontal lobe epilepsy than with other lobar localisations.
This means that, in the appropriate specialist context:
left-sided postictal weakness can support evidence for right-hemisphere seizure involvement
and vice versa.
But it is only one clue.
Specialists still interpret it alongside information from:
seizure semiology
EEG
MRI
video telemetry
neuropsychological testing
and, where necessary, other presurgical investigations.
Todd’s paresis should not be used by itself to diagnose where epilepsy originates.
It is particularly associated with motor cortex involvement
Motor movement is organised primarily within regions of the frontal lobes, particularly the primary motor cortex and connected motor networks.
The ILAE semiology glossary notes that Todd’s paresis generally develops following ictal involvement of the motor cortex and is most often seen in frontal lobe seizures.
That does not necessarily mean:
Todd’s paresis = frontal lobe epilepsy.
A seizure arising elsewhere can propagate into frontal motor networks.
This is an important distinction between:
where a seizure starts
and:
which networks it later recruits.
Can Todd’s paresis affect both sides?
Yes, although this is less usual.
Postictal paresis is classically unilateral.
However, bilateral weakness has been documented.
ILAE guidance explicitly notes that postictal paresis can occasionally be bilateral, and published epilepsy literature contains documented cases of bilateral Todd’s paralysis after focal seizures.
So unilateral weakness is typical, but it is not an absolute requirement.
Can it affect the face?
Yes.
Todd’s paresis can involve different combinations of:
face
arm
hand
leg
depending on which motor networks were affected.
The classic prospective study of post-epileptic paralysis found considerable variability in both the distribution and severity of weakness.
A person might therefore have:
arm weakness without obvious leg weakness
or:
face, arm and leg weakness together.
That variability is one of the reasons it can resemble stroke so closely.
Does the limb always look completely paralysed?
No.
Severity ranges from subtle weakness to complete inability to produce voluntary movement.
Someone may simply notice:
reduced grip strength
difficulty lifting an arm
dragging a foot
difficulty standing
or reduced coordination because the limb is weak.
At the more severe end, the affected limb may appear completely paralysed.
The same person does not necessarily experience exactly the same severity after every seizure.
Muscle tone and reflexes are not always the same
Todd’s paresis is not defined by one particular pattern of:
muscle tone
reflexes
or degree of weakness.
In the classic prospective study, affected people showed varying combinations of:
flaccid tone
normal tone
increased tone
reduced reflexes
normal reflexes
or increased reflexes.
So the bedside neurological picture can be heterogeneous.
This is another reason clinical assessment is needed rather than relying on a simple checklist.
How long does Todd’s paresis last?
There is no exact duration.
ILAE semiology guidance describes Todd’s paresis as generally lasting:
minutes to hours.
In the prospective study of 229 people with generalised tonic–clonic seizures, documented postictal paralysis lasted from approximately:
30 minutes to 36 hours
with an average of about 15 hours among those affected.
Those figures describe one study population.
They should not be treated as a countdown by which every person's weakness must disappear.
Can it last longer than a day?
Yes, prolonged postictal deficits are documented.
However, the longer a focal deficit continues, the more important it becomes to consider whether something else is happening.
A 2026 study specifically examined people with prolonged apparent postictal deficits.
Among 112 selected patients, 86 were ultimately considered to have uncomplicated Todd’s palsy, while 26 — 23% of this highly selected hospital population — had recurrent non-convulsive seizures detected during evaluation.
Median deficit duration was:
approximately 1.5 days in the uncomplicated Todd’s group
and approximately 2.5 days in those with recurrent non-convulsive seizures.
This does not mean 23% of ordinary Todd’s paresis cases involve continuing seizures.
These were specifically patients being investigated because their deficits were prolonged.
It does show why unusually persistent weakness deserves further assessment rather than simply being labelled postictal.
Does it happen after every seizure?
No.
Someone may experience Todd’s paresis:
after one seizure
after some seizures
after a particular type of seizure
or only once.
The prospective clinical study found that Todd’s paralysis could appear after a person's first seizure or after many years of epilepsy, and did not necessarily occur after every seizure.
That means:
“They never had weakness after their previous seizures”
does not prove that a new deficit cannot be Todd’s paresis.
But because new weakness also has other important causes, a first episode still deserves careful assessment.
Why does Todd’s paresis happen?
The precise biological mechanism remains uncertain.
Historically, explanations included the idea that motor neurons simply became:
“exhausted”
following intense seizure activity.
Modern research suggests a more complicated picture.
Possible contributors include temporary changes in:
neuronal inhibition
electrical network activity
metabolism
cerebral blood flow
vascular regulation
and communication within motor networks.
The major review of the postictal state emphasises that the mechanisms underlying postictal neurological deficits remain incompletely understood.
So describing Todd’s paresis simply as:
“the muscles being tired after a seizure”
would be inaccurate.
The weakness originates from temporary dysfunction within the nervous system, not merely from muscle fatigue.
Postictal changes in blood flow may contribute
Brain imaging studies have identified changes in cerebral perfusion around seizures.
During active seizure activity, involved cortex often shows increased blood flow.
After the seizure, some regions can show:
reduced blood flow
normal blood flow
or occasionally continued increased perfusion.
Postictal hypoperfusion has therefore been proposed as one mechanism contributing to transient neurological deficits.
But it is not sufficiently consistent to serve as a simple diagnostic marker.
A 2026 review of seizure-versus-stroke imaging emphasised that postictal hypoperfusion can overlap with the appearance of acute ischaemic stroke, while seizure-related MRI and perfusion abnormalities may also be reversible or non-territorial.
Todd’s paresis is not muscle soreness
After a tonic–clonic seizure, someone may feel weak because their muscles are:
sore
stiff
physically exhausted
or injured.
That is different from Todd’s paresis.
Todd’s paresis is a focal neurological motor deficit.
For example:
both legs feeling aching and exhausted after a tonic–clonic seizure
is different from:
the right arm and right leg temporarily losing strength because of postictal neurological dysfunction.
The two can, however, occur at the same time.
Related Information Hub page:
Muscle Pain and Physical Recovery After Convulsive Seizures
Todd’s paresis and stroke can look almost identical
This is the most important clinical issue.
A stroke may cause:
weakness on one side
facial drooping
difficulty speaking
altered sensation
visual problems
or other focal neurological deficits.
Todd’s paresis can also cause sudden focal weakness after a seizure.
The appearances can overlap dramatically.
Modern reviews describe postictal Todd’s phenomena as one of the important stroke mimics encountered in acute neurological practice.
A witnessed seizure does not automatically rule out stroke
This point is crucial.
It might seem logical to think:
“We saw a seizure, so the weakness afterwards must be Todd’s paresis.”
That is not safe reasoning.
A stroke itself can sometimes provoke a seizure.
The sequence can therefore be:
stroke → seizure → persistent weakness
rather than:
seizure → Todd’s paresis.
The 2026 review of stroke versus seizure emphasises exactly this diagnostic difficulty and the importance of combining clinical assessment with neuroimaging and, when appropriate, EEG.
So the presence of a seizure does not remove stroke from consideration.
New sudden weakness should be treated seriously
When sudden focal weakness is new or unexplained, stroke assessment may be required.
For example, current UK NICE neurological guidance states that sudden-onset limb weakness, even when limited to a small area such as one hand, may be caused by stroke or transient ischaemic attack and should be assessed through the appropriate stroke pathway.
That is UK guidance, but the underlying medical principle is international:
new sudden focal neurological weakness requires prompt assessment when stroke has not been confidently excluded.
Emergency numbers and stroke pathways vary by country.
Imaging can help — but no single scan always solves the problem
Clinicians may use:
non-contrast CT
CT angiography
CT perfusion
MRI
diffusion-weighted MRI
perfusion imaging
and other techniques
when trying to distinguish stroke from a seizure-related deficit.
However, this is not always straightforward.
A postictal brain can itself show temporary imaging abnormalities.
CT perfusion can be misleading
Stroke usually produces reduced blood flow in a distribution related to an affected artery.
Seizure-related perfusion abnormalities are often:
cortical
non-territorial
and not associated with a corresponding arterial blockage.
That can provide useful diagnostic clues.
But postictal states can also produce hypoperfusion, which may resemble ischaemia.
A review of CT perfusion stroke mimics reported that postictal patients could show:
normal perfusion
hypoperfusion
or hyperperfusion.
The overlap means that CT perfusion by itself may not reliably separate Todd’s paresis from stroke.
A more recent case series similarly demonstrated patients with Todd’s paralysis whose CT perfusion patterns closely resembled an ischaemic penumbra.
MRI can also show seizure-related abnormalities
Diffusion-weighted MRI is extremely important for detecting acute ischaemia.
But seizures can occasionally produce temporary:
diffusion changes
cortical signal abnormalities
and perfusion changes
that complicate interpretation.
Conversely, some genuine strokes can initially be difficult to visualise.
This is why clinicians integrate:
imaging
timing
vascular anatomy
neurological examination
witnessed seizure information
EEG
and the evolution of symptoms.
There is currently no single perfect test that identifies every case of Todd’s paresis and excludes every stroke.
Improvement over time can provide a clue — but should not delay stroke assessment
Todd’s paresis is temporary.
Strength gradually returns.
That improvement can eventually support the diagnosis.
But waiting for the weakness to disappear before deciding whether a stroke occurred may be unsafe when the deficit is new.
Stroke treatments are time-sensitive.
So spontaneous improvement is useful information after appropriate assessment has begun, not a reason to delay emergency evaluation.
What about someone with established epilepsy who has had Todd’s paresis before?
Some people develop a highly recognisable pattern.
For example:
usual focal seizure → right-sided weakness → strength gradually returns over 30 minutes.
Knowing that established pattern can be clinically useful.
Their epilepsy care plan may document it.
However, even an established history does not mean every future episode of weakness must be Todd’s paresis.
Particular attention is warranted when:
the weakness is much more severe than usual
it affects a different side
it lasts substantially longer
it begins without the person's usual seizure
there are new neurological symptoms
the person has stroke risk factors
or the event otherwise differs from their normal pattern.
Could continuing seizure activity cause the weakness?
Sometimes.
A person who appears to be postictal may actually have continuing or recurrent non-convulsive seizure activity.
This becomes especially important when neurological deficits are prolonged.
The 2026 study of prolonged postictal deficits found recurrent non-convulsive seizures in a significant minority of its selected hospital population, supporting the use of EEG when the clinical situation raises concern.
So prolonged weakness can create at least three important possibilities:
Todd’s paresis
stroke or another structural neurological event
or:
continuing/recurrent seizure activity.
Those possibilities cannot always be separated from observation alone.
EEG answers a different question from brain imaging
When a deficit persists, clinicians may need both EEG and imaging because they are looking for different things.
Imaging can investigate:
stroke
bleeding
structural lesions
seizure-related imaging changes
and other abnormalities.
EEG can help identify:
continuing epileptic activity
non-convulsive seizures
or other electrical abnormalities.
Neither automatically replaces the other.
Related Information Hub pages:
EEG — What It Can and Cannot Tell You About Epilepsy
MRI and Epilepsy — What Doctors Are Looking For
Can Todd’s paresis happen after a first-ever seizure?
Yes.
A person does not need an established epilepsy diagnosis before a postictal deficit can occur.
The classic prospective study found Todd’s paralysis could occur following a first seizure.
But this situation requires particular caution.
A first seizure followed by new focal weakness can be associated with:
stroke
tumour
structural brain disease
infection
metabolic disturbance
or another acute neurological problem.
The weakness therefore should not simply be labelled Todd’s paresis without appropriate investigation.
Structural brain abnormalities may be relevant
Older and contemporary research suggests Todd’s paresis may occur particularly in people with focal structural brain abnormalities.
In the prospective series of 14 patients with Todd’s post-epileptic paralysis, eight had underlying focal brain lesions associated with their seizures.
This does not mean everyone with Todd’s paresis has an MRI-visible lesion.
But a new focal postictal deficit can provide another reason for clinicians to consider whether an underlying structural cause needs investigation.
Related Information Hub page:
What Causes Epilepsy?
Does Todd’s paresis damage the limb?
Todd’s paresis is caused by temporary dysfunction of the nervous system.
The weak arm or leg itself is not normally paralysed because its muscles have been structurally damaged by the postictal deficit.
As the neurological dysfunction resolves, strength returns.
However, temporary weakness can indirectly create risks.
Someone may:
fall
buckle at the knee
drop objects
be unable to use stairs safely
or injure themselves attempting to walk before strength returns.
So practical safety still matters during recovery.
Do not force a weak limb to work normally
Todd’s paresis is not usually something a person can overcome simply by:
trying harder
repeatedly standing up
exercising the limb immediately
or being encouraged to “walk it off”.
Until strength returns, support should focus on preventing:
falls
further injury
and unsafe movement.
Formal rehabilitation is generally unnecessary for a brief deficit that resolves completely.
Persistent weakness requires reassessment because it may no longer fit an uncomplicated postictal pattern.
Recording the pattern can be clinically useful
If Todd’s paresis occurs repeatedly, a seizure diary can record:
which side became weak
which body parts were affected
when the weakness first became apparent
how severe it was
whether the person could stand
whether the face was affected
when movement began returning
approximately when normal strength returned
and whether the pattern followed a particular seizure type.
Video may also be useful when it can be obtained safely and without delaying medical care.
The pattern can provide specialists with useful semiological information.
Related Information Hub page:
Seizure Diaries and Videos — How to Record Useful Evidence
Why does the side matter?
Seizure specialists pay close attention to whether the deficit is:
left-sided
right-sided
bilateral
or confined to one body region.
The 2026 systematic review found postictal paresis to be a particularly useful contralateral lateralising sign in the studies examined.
For example:
right-sided Todd’s paresis
may support evidence for involvement of:
left-hemisphere motor networks.
But specialists never rely on that information alone.
A seizure may spread through several networks before ending, and other neurological diseases can produce the same weakness pattern.
Todd’s paresis is one member of a broader family of postictal focal deficits
Temporary motor weakness is the classic example, but seizures can also be followed by other focal neurological disturbances.
These can include temporary problems involving:
speech and language
vision
gaze
sensation
memory
or other functions.
Some literature uses the broader expression Todd’s phenomenon for these postictal focal deficits.
For clarity, this Information Hub uses Todd’s paresis specifically for temporary postictal motor weakness.
The other deficits are covered separately.
Related Information Hub page:
Postictal Speech and Language Problems
Weakness and language problems can occur together
If a seizure has involved networks controlling both movement and language, somebody may have:
weakness on one side
and difficulty speaking or understanding language.
This combination can look extremely similar to a major stroke.
In the older prospective study of Todd’s paralysis, some patients also had aphasia or gaze palsy.
This overlap reinforces why acute focal deficits require proper neurological assessment rather than being attributed automatically to epilepsy.
A seizure is one of the major stroke mimics — but stroke is not a “mimic” until it has been excluded
The phrase stroke mimic is used medically for conditions that present like stroke but ultimately have another cause.
Seizures and postictal neurological deficits are among the important examples.
However, at the moment somebody develops new sudden weakness, clinicians may not yet know whether they are seeing:
true stroke
Todd’s paresis
continuing seizure activity
migraine
a metabolic disturbance
or another neurological problem.
The safest approach is therefore not:
“They have epilepsy, so it must be their epilepsy.”
It is:
“They have a new focal neurological deficit. What caused it?”
When is urgent assessment especially important?
Urgent medical assessment is particularly important when weakness:
is occurring for the first time
develops without a clearly recognised seizure
is substantially different from the person's established pattern
affects a different side than usual
is accompanied by new speech or visual problems
is associated with severe headache
follows significant head injury
is worsening rather than improving
remains unexpectedly prolonged
or occurs alongside persistent altered consciousness or further seizures.
Sudden new weakness can represent stroke even in someone who already has epilepsy.
Emergency numbers and stroke pathways vary by country.
What happens if it is Todd’s paresis?
Uncomplicated Todd’s paresis is transient.
Strength returns as the postictal neurological deficit resolves.
There is no established medicine whose purpose is specifically to reverse ordinary Todd’s paresis immediately.
Management instead centres on:
confirming that another acute cause is not responsible
treating the underlying epilepsy appropriately
preventing injury while the person is weak
and observing recovery.
The broader postictal literature notes that treatments specifically targeting postictal deficits remain poorly established in clinical trials.
Preventing the seizure is the main way of preventing recurrence
Because Todd’s paresis occurs as a consequence of a seizure, reducing the seizures that produce it is the most direct way of reducing the risk of recurrent episodes.
This may involve reviewing:
seizure control
medication
seizure classification
underlying structural causes
adherence
or other treatment possibilities.
The detailed treatment pathway belongs elsewhere in the Hub.
Related Information Hub page:
How Is Epilepsy Treated?
Todd’s paresis contributes to seizure burden
Todd’s paresis also illustrates why measuring epilepsy only by seizure duration can be misleading.
Consider:
Seizure: two minutes.
Postictal weakness: six hours.
The person's inability to:
walk independently
use one arm
return to work
care for themselves
or safely continue normal activity
may last far longer than the electrical seizure itself.
That recovery period is part of the real functional burden of the event.
The most important message
Todd’s paresis is temporary weakness caused by postictal dysfunction after an epileptic seizure.
It can range from:
mild weakness
to:
complete temporary paralysis.
It may involve:
the face
an arm
a leg
one whole side of the body
or, rarely, both sides.
ILAE guidance describes it as occurring particularly after focal motor or focal-to-bilateral tonic–clonic seizures and usually lasting from minutes to hours.
A 2026 systematic review found that postictal paresis was consistently contralateral to the epileptic focus in the evidence reviewed, making it a potentially valuable lateralising sign during specialist epilepsy assessment.
But there is an equally important message:
new sudden weakness cannot safely be assumed to be Todd’s paresis simply because someone has had a seizure or has epilepsy.
Stroke can:
look like Todd’s paresis
occur independently in someone with epilepsy
and sometimes cause a seizure itself.
Imaging can help, but seizure-related changes can sometimes resemble stroke, so diagnosis may require integration of:
the history
neurological examination
imaging
EEG
timing
and how the deficit evolves.
Todd’s paresis is temporary.
Until another acute cause has been appropriately excluded, sudden new weakness deserves to be taken seriously.
Related Information Hub pages
After the Seizure — Understanding the Postictal State
Postictal Confusion and Memory Loss
Postictal Exhaustion and Sleep
Postictal Speech and Language Problems
When Recovery Is Taking Too Long
Focal, Generalised, Unknown and Unclassified Seizures — Understanding the 2025 ILAE Classification
EEG — What It Can and Cannot Tell You About Epilepsy
MRI and Epilepsy — What Doctors Are Looking For
Seizure Diaries and Videos — How to Record Useful Evidence
Sources and further reading
International League Against Epilepsy — Seizure semiology: ILAE glossary of terms and their significance
Describes Todd’s paresis as a postictal motor deficit following focal motor or focal-to-bilateral tonic–clonic seizures, generally lasting minutes to hours and usually lateralising to the contralateral hemisphere.
Parikh P and colleagues — Lateralizing and localizing value of postictal signs: A systematic review — Epileptic Disorders, 2026
Current systematic review assessing postictal signs in focal epilepsy. Postictal paresis consistently occurred contralateral to the epileptic focus in the evidence reviewed and was more strongly associated with frontal epilepsy than other lobar localisations.
Gallmetzer P and colleagues — Postictal paresis in focal epilepsies: incidence, duration, and causes — Neurology, 2004
Video-EEG study investigating the occurrence, duration and seizure characteristics associated with postictal motor deficits.
Rolak LA and colleagues — Clinical features of Todd’s post-epileptic paralysis — Journal of Neurology, Neurosurgery & Psychiatry, 1992
Prospective study showing the considerable variation in distribution and severity of Todd’s paralysis and documenting deficits lasting from 30 minutes to 36 hours in the affected group.
Pottkämper JCM and colleagues — The postictal state: What do we know? — Epilepsia, 2020
Comprehensive review of postictal neurological deficits, their proposed mechanisms, duration and the difficulty of distinguishing Todd’s paresis from stroke.
Kermorvant H and colleagues — Prolonged postictal deficit: Uncomplicated Todd’s palsy or nonconvulsive status epilepticus? — Epilepsia, 2026
Recent study demonstrating that recurrent non-convulsive seizures can account for a proportion of unusually prolonged apparent postictal deficits, highlighting the importance of EEG when recovery is atypically prolonged.
Stroke or Seizure? Diagnostic Role of Neuroimaging in Acute Neurologic Mimics — 2026
Current review of CT, MRI and perfusion imaging in distinguishing acute ischaemic stroke from seizure-related neurological deficits and the diagnostic limitations caused by overlapping imaging findings.
NICE NG127 — Suspected neurological conditions: recognition and referral
UK-specific guidance stating that sudden-onset limb or facial weakness may represent stroke or transient ischaemic attack and should be assessed through appropriate stroke pathways.
Information reviewed: September 2026.
This page provides general educational information for an international audience. Sudden new weakness can have several causes, including stroke, and should not automatically be attributed to epilepsy. Emergency numbers, stroke pathways and healthcare systems vary between countries.