This case demonstrates that episodes of both hypokalemic and hyperkalemic weakness can occur in a single individual, which should be considered in pathogenic postulates regarding periodic paralysis.
Alerts clinicians to mixed hyper- and hypokalemic episodes in one patient; leaves open shared mechanisms in periodic paralysis pathogenesis.
A young man with episodes characteristic of familial normokalemic periodic paralysis was restudied after a change in the nature of his attacks. He now has spontaneously occurring and provokable episodes of both hyperkalemic and hypokalemic periodic paralyses that are superimposed on a persistent myopathy. Hypokalemia seems to be associated with facilitated entry of glucose and potassium into muscles, whereas resistance to glucose and potassium entry accompanies hyperkalemia. The possibility that episodes of both hypokalemic and hyperkalemic weaknesses can occur in one person should be considered in pathogenic postulates regarding periodic paralysis.
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Chesson et al. (1979) studied this question.
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