Dr. Zuhal Kadhim
Emory University School of Medicine, Atlanta, GA.
Introduction: Periodic paralysis is a group of rare neuromuscular disorders presenting with episodes of painless paralysis often incited by stress such as exercise. Differentiating hypokalemic periodic paralysis (HPP) from secondary hypokalemia can present a challenge. Case Report: A 26-year-old Hispanic male with no significant past medical history presented with periodic muscular weakness, areflexia, and paralysis. The patient’s potassium level on admission was 1.6 mEq/l with no other electrolyte abnormalities or electrocardiogram changes. There was a complete resolution of symptoms with IV and oral potassium. The diagnosis of acquired non-thyrotoxic HPP was given based on the patient’s history, his presenting symptoms, ruling out secondary causes of hypokalemia, and resolution with correction of potassium levels. Conclusion: Hypokalemic periodic paralysis most commonly affects Asians, and is tightly associated with thyrotoxicosis. Treatment of HPP relies on rapid identification and understanding of underlying cause. In an acute disabling attack, as seen in this patient, oral potassium and 24 hour cardiac monitoring for rebound hyperkalemia are recommended. We report an uncommon case of acquired non-thyrotoxic HPP, as indicated by the patient’s history, presentation, initial laboratory values, and resolution after potassium correction. Keywords: Muscular weakness, Non-thyrotoxic hypokalemic, Periodic paralysis, Potassium level.