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Thyrotoxic periodic paralysis-still a diagnostic challenge.

Ravi Kara Patti¹, Avleen Kaur², Navjot Somal¹

¹Pulmonary and Critical Care, Maimonides Medical Center, Brooklyn, New York.

Proceedings (Baylor University. Medical Center)

|October 28, 2022

Summary

Thyrotoxic periodic paralysis, a severe complication of thyrotoxicosis, causes acute muscle weakness and hypokalemia. Early diagnosis and treatment of thyrotoxicosis are crucial for recovery.

Keywords:

Graves' disease hyperpolarization hyperthyroidism hypokalemia periodic paralysis

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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.