Ophthalmoparesis and Bilateral Ptosis as a Rare Manifestation of Todd's Phenomenon: Case Report and Review

Abstract

Todd's paresis or phenomenon (TP) is a focal weakness in a part of the body after a seizure. Seizure is an abrupt change in behavior caused by the cerebral cortex's electrical hyper-synchronization of neuronal networks. After the seizure, there is usually a transition period from the ictal state to the pre-seizure baseline level of awareness and function, referred to as the postictal period. Postictal symptoms include many systems, including sensory, motor, and psychosis. This phenomenon is named after Robert Bentley Todd, who first described it. Todd's paresis can be confused with other conditions, most commonly a stroke. Postictal ocular manifestation may be accompanied by aphasia or hemiplegia, but isolated gaze palsy is rarely reported. We are reporting a rare and first known isolated ophthalmoparesis and ptosis as postictal findings with no structural abnormalities present in imaging studies and complete resolution over three weeks on its own as an atypical postictal phenomenon. Patients with an underlying structural abnormality of the brain are more susceptible to Todd's phenomenon. Unusual manifestations of Todd's phenomenon are rare but clinically relevant and are decisive in therapeutic decision-making. Our patient presents a rare manifestation of Todd's phenomenon as ptosis and ophthalmoparesis in an elderly male with no underlying structural brain abnormalities that resolved within three weeks. Further research into the causes is needed to distinguish it from a stroke

The Antifungal Potential of Niclosamide and Structurally Related Salicylanilides

“…Hence, they have the potential to prevent or overcome resistance to currently applied drugs. Since niclosamide was shown to possess distinct antiviral activities against SARS-CoV-2 and HIV, and fungal co-infections in several viral infections (e.g., cryptococcocal meningitis in HIV patients and candidiasis, aspergillosis, and mucormycosis in COVID-19 patients), antifungal salicylanilides can kill two birds with one stone and tackle both life-threatening infections in patients [132][133][134][135]. The pharmacological properties of niclosamide are well elaborated and provide useful hints at a proper administration of the drug for patients suffering from various mycoses.…”