Key result
IV potassium chloride and propranolol resolve sudden lower limb weakness in thyrotoxic periodic paralysis.
Case Report (n=1)
No
May prompt TPP consideration in acute paralysis without overt thyrotoxicosis; Level 5 data leaves open prospective validation.
Hyperthyroidism rarely cause paralysis by redistributive hypokalemia, with periodic attacks of paralysis termed as thyrotoxic periodic paralysis (TPP). It is more commonly seen in the Asian or Hispanic populations, genetic variation in Kir2.6, a muscle specific thyroid hormone responsive potassium channel cause predisposition of TPP. It typically presents in the early morning with limb weakness. Hyperthyroidism signs and symptoms are need not to be present in all patients. TPP attacks can be triggered by factors such a high-carbohydrate diet, sternous activity, mental stress, and steroids. TPP should be suspected in young patients presenting with acute muscle weakness and severe hypokalemia. Arrhythmias can be noted but most of these will resolve with normalization of potassium.
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R. et al. (2023) conducted a case report in Thyrotoxic periodic paralysis (n=1). Potassium chloride and IV propranolol was evaluated on Recovery from paralysis and normalization of serum potassium. Intravenous potassium chloride and propranolol successfully normalized serum potassium and resolved sudden onset bilateral lower limb weakness in a 43-year-old male with thyrotoxic periodic paralysis.
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