Thyrotoxic periodic paralysis-still a diagnostic challenge

Area of Science:

• Endocrinology
• Neurology

Background:

• Thyrotoxic periodic paralysis (TPP) is a rare but life-threatening condition.
• It presents as acute muscle paralysis and severe hypokalemia in patients with hyperthyroidism.

Observation:

• A 24-year-old male presented with progressive lower extremity weakness and urinary retention.
• Physical examination revealed proximal muscle weakness and absent reflexes.
• Laboratory tests showed critically low potassium levels (1.3 mmol/L).

Findings:

• The patient was diagnosed with new-onset thyrotoxicosis.
• Treatment included methimazole, propranolol, and potassium supplementation.
• Serum potassium normalized to 4.7 mmol/L, leading to gradual motor function recovery.

Implications:

• This case underscores the importance of considering endocrine disorders in acute flaccid paralysis.
• Prompt diagnosis and management of thyrotoxicosis are vital for preventing severe neurological complications.
• Highlights the critical role of electrolyte balance in neuromuscular function.