Hypokalemic Periodic Paralysis — The Syndrome and its Treatment

Hypokalemic periodic paralysis (hypoKPP) is a genetically determined disease characterized by episodic decreases in serum potassium levels accompanied by muscle weakness or paralysis. A case is reported and a review of the literature presented. Current evidence suggests that the primary defect associated with hypoKPP resides either in the muscle cell membranes or in the cellular metabolism and gives rise to a conduction defect which results in muscle paralysis. A variety of drugs have been employed to correct the cellular abnormality, including supplemental potassium, diuretics, propranolol and diazoxide. To date the most effective therapy is acetazolamide, which induces a mild metabolic acidosis thought to stabilize the cellular membrane against intracellular shifts of potassium ions.