[Hypokalemic periodic paralysis as the sole manifestation of hyperthyroidism]

Hypopotassaemic periodic paralysis as the sole manifestation of hyperthyroidism. Hypopotassaemic periodic paralysis is a rare disorder that is found in certain families, sporadically or in association with certain diseases. The association with hyperthyroidism is almost wholly restricted to south-east Asian males. It is characterized by attacks of subacute paralysis, starting most often early in the morning and lasting some hours to a few days. We present a 42-year-old patient of Indonesian origin, who experienced four attacks of paralysis before underlying hyperthyroidism was diagnosed. The mechanism is based on potassium shift into the muscle cell due to higher activity of the Na-K-ATP-ase pump, under the influence of beta-adrenergic stimulation and thyroid hormone. Treatment with antithyroidal medication and beta-blockers led to the complete abolition of attacks.