The effect of acidosis in hypokalemic periodic paralysis

Metabolic acidosis was produced in two patients with hypokalemic periodic paralysis by the administration of ammonium chloride over a period of three days. The challenging test of glucose and insulin produced a substantially smaller reduction of both serum potassium concentration and muscle strength than when the patients were tested in normal acid-base balance. The findings agree with earlier work on acetazolamide, suggesting that metabolic acidosis provides protection against episodes of muscle weakness in periodic paralysis.