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Periodic Paralysis—Hyperkalemic/Hypokalemic
Published in Charles Theisler, Adjuvant Medical Care, 2023
Hyperkalemic periodic paralysis is a condition that causes episodes of extreme muscle weakness or paralysis, usually beginning in infancy or early childhood. Attacks are usually brief, lasting a few minutes to an hour or two, but tend to occur frequently. Most often, these episodes involve a temporary inability to move muscles in the arms and legs. Some people with hyperkalemic periodic paralysis have elevated serum levels of potassium (hyperkalemia) during attacks. Hyperkalemia results when the weak or paralyzed muscles release potassium ions into the bloodstream. In most patients, potassium levels do not actually rise above normal. Hyperkalemic refers more to the fact that attacks may be triggered by eating potassium-rich foods or by giving the patient potassium.
Neurology
Published in Fazal-I-Akbar Danish, Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Respiratory paralysis:1 Transection/compression of upper cervical spinal cord.2 Transverse myelitis.3 GB syndrome.4 Myasthenia gravis.5 Botulism.6 In most patients with motor neuron disease and muscular dystrophies (as part of the terminal illness).7 K+-related periodic paralysis.8 Snake bite.
Neurogenetics
Published in John W. Scadding, Nicholas A. Losseff, Clinical Neurology, 2011
Sonia Gandhi, Sarah Tabrizi, Nicholas Wood
Myotonia is a disorder in which muscle stiffness occurs as a result of failure of muscle relaxation. Myotonia congenita may be dominant (Thomsen’s disease) or recessive (Becker’s disease). Myotonia may be detected clinically or on electromyography (EMG). Both types are caused by mutations in the muscle chloride channel gene (CLCN1). Paramyotonia congenita is a myotonic autosomal dominant disorder that occurs during exercise and, in contrast to myotonia congenita, worsens with activity. This disorder is caused by mutations in the muscle sodium channel SCN4A, which also causes hyperkalaemic periodic paralysis.
Thyrotoxic periodic paralysis: a presentation of hyperthyroidism increasing in frequency around the world
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2023
Periodic paralysis should be considered in patients with sudden-onset paralysis and hypokalaemia. Thyrotoxicosis is a rare form of acquired periodic paralysis that is no longer confined to Asian populations due to global expansion. Clinicians should have a high index of suspicion for this diagnosis as the signs and symptoms of thyrotoxicosis are often subtle. If left untreated, hypokalaemia is likely to recur and may result in grave cardiac arrythmias. Treatment includes potassium supplementation and the use of non-selective beta blockers, such as propranolol. Definitive treatment remains the management of the underlying hyperthyroidism. Due to the potassium shift and no true potassium losses, regular serum potassium levels should be checked during supplementation to avoid rebound hyperkalaemia. Clinicians should also guard against aggressive potassium supplementation. With the expansion of globalisation, clinicians are more likely to encounter thyrotoxic periodic paralysis in all corners of the globe; awareness of this condition is thus imperative.
Novel mutations of the SLC12A3 gene in patients with Gitelman syndrome
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2021
Feng Wang, Manli Guo, Jing Li, Shaogang Ma
GS combined with hyperthyroidism can manifest as frequent episodes of periodic paralysis. Based on our results, the existing cases prompted us to more seriously consider the possibility of GS associated with thyroid dysfunction [11]. A better understanding of the mutated channels and transporters could generate targets for specific diagnosis and treatment in the future.