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Thyrotoxic periodic paralysis presenting with quadriparesis and hyperreflexia.
Yoji Hoshina1, Hana Setterquist2, Tegan D McConnell3
1Neurology, University of Utah Health, Salt Lake City, Utah, USA yojihoshina0106@gmail.com.
BMJ Case Reports
|December 30, 2023
Summary
Thyrotoxic periodic paralysis (TPP), a rare hyperthyroidism complication, can present with muscle spasticity, not just flaccid paralysis. Early diagnosis and treatment are crucial for recovery.
Area of Science:
- Endocrinology
- Neurology
Background:
- Thyrotoxic periodic paralysis (TPP) is a rare neuromuscular complication of hyperthyroidism.
- It typically presents as episodes of painless, flaccid paralysis.
Observation:
- A young East Asian male presented with acute quadriparesis, hypertonia, and hyperreflexia.
- Neuroaxis MRI was normal, but serum potassium was low, and thyroid tests indicated hyperthyroidism.
Findings:
- The patient was diagnosed with TPP secondary to Graves' disease.
- Treatment with potassium, propranolol, and methimazole led to motor strength recovery.
Implications:
- This case underscores that TPP can manifest with hypertonia and hyperreflexia, atypical symptoms.
- Clinicians should consider TPP in patients with acute quadriparesis, even with non-flaccid presentations.
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