Robert Bentley Todd

Robert Bentley Todd (1809-1860)

Robert Bentley Todd (1809-1860) was an Irish physician.

Provided early depictions of migraine, peripheral neuritis, and postepileptic paralysis (Todd’s palsy). He also gave an important discourse on locomotor ataxy (tabes dorsalis).

Described patients with a ‘march of focal seizures’ prior to Hughlings Jackson


Biography

  • Born 9 April 1809 in Dublin
  • 1825 – started studying for the bar at Trinity College, Dublin but was advised to switch to medicine the following year after his father’s death, a former president and professor of surgery and anatomy at the Royal College of Surgeons in Ireland (RCSI)
  • 1829 – graduated B.A at Trinity College
  • 1831 – licensed at the RCSI
  • 1837 – Professor of Physiology, King’s College London
  • 1838 – Fellow of the Royal College of Physicians
  • 1839 -1859 – Physician, King’s College Hospital
  • 1842 – Croonian lecturer on “Practical remarks on gout, rheumatic fever and chronic rheumatism of the joints”
  • 1844 – Fellow of the Royal College of Surgeons
  • 1849 – Lumleian lecturer “On the pathology and treatment of convulsive diseases”
  • 1848 – Co-founder St. John’s Training Institution for Nurses
  • Died 20 January 1860 of a gastric haemorrhage secondary to hepatic cirrhosis

Medical Eponyms

Todd’s palsy (1849)

A paralytic state remains sometimes after the epileptic convulsion. This is more particularly the case when the convulsion has affected only one side or one limb: that limb or limbs will remain paralytic for some hours, or even days, after the cessation of the paroxysm, but it will ultimately perfectly recover.

Robert Todd – Lumleian lecture 1849

Todd first mentioned a post-ictal paralysis in his 1849 Lumleian lecture but clarified the syndrome more in his Clinical lectures using three illustrative cases of what he called “Epileptic Hemiplegia”. While Todd didn’t provide the refined description we use today he concluded that “the distinction of a form of hemiplegia in connection with the epileptic paroxysm is well founded”.

Nowadays Todd’s palsy refers to a focal weakness following a seizure, usually a focal motor seizure in a limb, that completely resolves usually within minutes but has been noted up to 48hrs. This can also include sensory, visual and speech deficits if the corresponding area has been affected.


Key Medical Attributions

  • Migraines
  • Peripheral neuritis
  • Postepileptic paralysis
  • Tabes dorsalis
  • Coined the terms “afferent” and “efferent” in Cyclopedia of Anatomy and Physiology

Controversies

Todd wasn’t the first to describe an epileptic hemiplegia. In a thesis submitted to the University of Paris in 1827, Bravais mentions “l’épilepsie hémiplégique” however scholars have tipped the scales in Todd’s favour deeming him the first to describe the condition in detail.

Ironically, perhaps Todd might not have desired the eponym to bear his name afterall:

I must say that I cannot regard it as any compliment to the great names of our profession, to attach them to any of the numerous ills which flesh is heir to.

Robert Todd on ‘Bell’s paralysis of the face’. 1854


Major Publications


References


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