Thyrotoxic Periodic Paralysis: A Unique Case Highlighting the Diagnostic Challenges and Management

Area of Science:

• Endocrinology
• Neurology
• Internal Medicine

Background:

• Thyrotoxic periodic paralysis (TPP) is a rare neuromuscular complication associated with thyrotoxicosis, predominantly seen in males with Graves' disease.
• It represents the most common form of acquired periodic paralysis, triggered by factors such as exertion, stress, diet, and medications.

Observation:

• A case report details a 30-year-old Middle Eastern man presenting with acute flaccid paralysis after exertion and high-carbohydrate intake.
• Clinical findings included severe hypokalemia, biochemical thyrotoxicosis (suppressed TSH, elevated T3/T4), and ECG abnormalities indicative of hypokalemia.

Findings:

• The patient was diagnosed with TPP and treated with potassium repletion and anti-thyroid medications, including beta-blockers.
• Successful treatment led to normalized potassium levels, restored muscle function, and prevention of recurrence through euthyroid state maintenance.

Implications:

• Investigating potassium levels and thyroid function in patients with acute flaccid paralysis is vital for diagnosing thyrotoxicosis complications.
• Early and aggressive management of TPP, combining hypokalemia correction and thyroid normalization, can avert severe cardiopulmonary complications and ensure patient recovery.