Key result
A 53-year-old woman developed severe hypokalemic non-periodic paralysis and pathognomonic ECG changes due to thiazide diuretic overuse and alcoholic malnutrition, which completely resolved with potassium and magnesium repletion.
Case Report (n=1)
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Severe hypokalemia from thiazide overmedication and alcohol abuse can present as non-periodic paralysis and characteristic ECG changes (pseudo-prolonged QT), which resolves with electrolyte repletion.
We describe the case of a patient presenting with odd neurologic symptoms initially thought to represent somatization who was found to have critical hypokalemia manifesting as hypokalemic non-periodic paralysis. It was determined that the patient had baseline hypokalemia as a function of alcohol abuse, exacerbated by self overmedication with hydrochlorothiazide for elevated blood pressure readings at home. The diagnosis was suspected when an electrocardiogram was obtained demonstrating a pseudo-prolonged QT interval with ST depression, consistent with T-U wave fusion and a QU interval with an absent T wave.1 The patient received oral and intravenous potassium and magnesium supplementation with resolution of symptoms.
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Schell et al. (2019) conducted a case report in Hypokalemic non-periodic paralysis (n=1). Hydrochlorothiazide overmedication was evaluated on Resolution of symptoms and electrolyte abnormalities. A 53-year-old woman developed severe hypokalemic non-periodic paralysis and pathognomonic ECG changes due to thiazide diuretic overuse and alcoholic malnutrition, which completely resolved with potassium and magnesium repletion.
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