The exercise test in periodic paralysis

Of 21 patients with clinically definite hypokalemic, hyperkalemic, or normokalemic periodic paralysis, 15 (71%) had a greater than normal increase in compound muscle action potential amplitude during 2-5 minutes of intermittent strong voluntary contraction of the muscle. This increase was followed by a progressive decline in amplitude, which was greater than in a control population and which was most rapid during the first 20 minutes after exercise. The amplitude often decreased to a level below the preexercise level. A similar response was seen in six of nine patients with periodic paralysis secondary to disorders such as thyrotoxicosis. This test may have value in the identification of patients with periodic paralysis.