Hypokalemic Periodic Paralysis: A case Report and Review of the Literature
Hypokalemic periodic paralysis (hypoPP) is a disorder that causes occasional episodes of muscle weakness and sometimes a lower than normal level of potassium in the blood during the attack. HypoPP is one of a group of genetic disorders that includes hyperkalemic periodic paralysis and thyrotoxic periodic paralysis among others.
A 45 year old male presented with quadriplegia for 1 day of sudden onset following heavy exercise one day before the attack, Laboratory evaluation revealed a markedly low potassium level of 1.7 meq/L, normal thyroid function test , and normal magnesium level .
The patient's paralysis resolved during replacement of his low potassium within 48 hours of ICU admission and he was discharged with no neurologic deficits.
He has a family history of similar condition (1st and 2nd degree relatives).
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(3):267-272.
2. Jurkat-Rott K, Lerche H, Lehmann-Horn F: Skeletal muscle channelopathies.JNeurol 2002, 249(11):1493-1502.
3. Lin SH, Lin YF, Chen DT, Chu P, Hsu CW, Halperin ML: Laboratorytests to determine the cause of hypokalemia and paralysis.Arch Intern Med 2004, 164(14):1561-1566.
4. Kelley DE, Gharib H, Kennedy FP, Duda RJ Jr, McManis PG: Thyrotoxicperiodic paralysis. Report of 10 cases and review ofelectromyographic findings. Arch Intern Med 1989,149(11):2597-2600.
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(4):359-363.
6. Okinaka S, Shizume K, Iino S, Watanabe A, Irie M, Noguchi A, KumaS, Kuma K, Ito T: The association of periodic paralysis and hyperthyroidism in Japan. J ClinEndocrinolMetab 1957,17(12):14541459.
7. Tassone H, Moulin A, Henderson SO: The pitfalls of potassiumreplacement in thyrotoxic periodic paralysis: a case report and review of the literature. J Emerg Med 2004, 26(2):157-161.
8. Ogawa T, Kamikubo K: Hypokalemic periodic paralysis associated with hypophosphatemia in a patient with hyperinsulinemia. Am J Med Sci 1999, 318(1):69-72.
9. Cannon SC: An expanding view for the molecular basis of familial periodic paralysis. Neuromuscul Disord 2002, 12(6):533-543.
10. Benjamin R Soule , Nicole Lsimone: Hypokalemic Periodic Paralysis: a case repor tCases Journal 2008, 1:256 doi:10.1186/1757-1626-1-256 .