Aisvarya Kapoor Attending Consultant, Department of Emergency Medicine, Max Healthcare, Shalimar Bagh, Delhi 110088, India
Pallavi Verma MEM Resident, Department of Emergency Medicine, Max Healthcare, Shalimar Bagh, Delhi 110088, India
Kishalay Datta Director and HOD, Department of Emergency Medicine, Max Healthcare, Shalimar Bagh, Delhi 110088, India
Uzma Khanam MEM Resident, Department of Emergency Medicine, Max Healthcare, Shalimar Bagh, Delhi 110088, India
Address for correspondence: Aisvarya Kapoor, Attending Consultant, Department of Emergency Medicine, Max Healthcare, Shalimar Bagh, Delhi 110088, India E-mail: aisvarya.girotra@gmail.com
This license enables
reusers to distribute, remix, adapt, and build upon the material in any medium
or format for noncommercial purposes only, and only so long as attribution is
given to the creator.
Received : March 11, 2022
Accepted : April 14, 2022
Published : September 25, 2022
Abstract
Hypokalemic (Induced) Periodic Paralysis is a rare group of disorders that can cause sudden onset of flaccid paralysis. Here we present a case of 41 year old female who presented to the ED complaining of severe flaccid paralysis in both lower & upper limbs since morning. Initially, she was treated as a stroke alert patient and had head scans which showed no acute pathologic changes. Laboratory evaluation revealed a markedly low potassium level. The patient's paralysis resolved after potassium correction and she was discharged with no neurologic deficits. Although rare, Periodic Paralysis must be differentiated from other causes of weakness and paralysis so that the proper treatment can be initiated quickly.
References
1. Fontaine B, Vale-Santos J, Jurkat-Rott K, Reboul J, Plassart E, Rime CS, Elbaz A, Heine R, Guimaraes J, Weissenbach J, et al. Mapping of the hypokalaemic periodic paralysis (HypoPP) locus to chromosome 1q31-32 in three European families. Nat Genet. 1994;6:267–272. doi: 10.1038/ng0394-267. [PubMed] [CrossRef] [Google Scholar]
3. Lin SH, Lin YF, Chen DT, Chu P, Hsu CW, Halperin ML. Laboratory tests to determine the cause of hypokalemia and paralysis. Arch Intern Med. 2004;164:1561–1566. doi: 10.1001/archinte.164.14.1561. [PubMed] [CrossRef] [Google Scholar]
4. Kelley DE, Gharib H, Kennedy FP, Duda RJ, Jr, McManis PG. Thyrotoxic periodic paralysis. Report of 10 cases and review of electromyographic findings. Arch Intern Med. 1989;149:2597–2600. doi: 10.1001/archinte.149.11.2597. [PubMed] [CrossRef] [Google Scholar]
5. Wang W, Jiang L, Ye L, Zhu N, Su T, Guan L, Li X, Ning G. Mutation screening in Chinese hypokalemic periodic paralysis patients. Mol Genet Metab. 2006;87:359–363. doi: 10.1016/j. ymgme.2005.10.020. [PubMed] [CrossRef] [Google Scholar]
6. Okinaka S, Shizume K, Iino S, Watanabe A, Irie M, Noguchi A, Kuma S, Kuma K, Ito T. The association of periodic paralysis and hyperthyroidism in Japan. J Clin Endocrinol Metab. 1957;17:1454–1459. [PubMed] [Google Scholar]
7. Shizume K, Shishiba Y, Kuma K, Noguchi S, Tajiri J, Ito K, Noh JY. Comparison of the incidence of association of periodic paralysis and hyperthyroidism in Japan in 1957 and 1991. Endocrinol Jpn. 1992;39:315–318. [PubMed] [Google Scholar]
8. Saeian K, Heckerling PS. Thyrotoxic periodic paralysis in a hispanic man. Arch Intern Med. 1988;148:708. doi: 10.1001/archinte.148.3.708. [PubMed] [CrossRef] [Google Scholar]
10. Tassone H, Moulin A, Henderson SO. The pitfalls of potassium replacement in thyrotoxic periodic paralysis: a case report and review of the literature. J Emerg Med. 2004;26:157–161. doi: 10.1016/j.jemermed.2003.05.004. [PubMed] [CrossRef] [Google Scholar]
11. Ogawa T, Kamikubo K. Hypokalemic periodic paralysis associated with hypophosphatemia in a patient with hyperinsulinemia. Am J Med Sci. 1999;318:69–72. doi: 10.1097/00000441-199907000-00012. [PubMed] [CrossRef] [Google Scholar]
12. Cannon SC. An expanding view for the molecular basis of familial periodic paralysis. Neuromuscul Disord. 2002;12:533–543. doi: 10.1016/S0960-8966(02)00007-X. [PubMed] [CrossRef] [Google Scholar]
Data Sharing Statement
There are no additional data available. All raw data and code are available upon request.
Funding
This research received no funding.
Author Contributions
All authors contributed significantly to the work and approve its publication.
Ethics Declaration
This article does not involve any human or animal subjects, and therefore does not require ethics approval.
Acknowledgements
We would like to express our gratitude to the patients, their families, and all those who have contributed to this study.
This license enables
reusers to distribute, remix, adapt, and build upon the material in any medium
or format for noncommercial purposes only, and only so long as attribution is
given to the creator.
This license enables
reusers to distribute, remix, adapt, and build upon the material in any medium
or format for noncommercial purposes only, and only so long as attribution is
given to the creator.