An interesting case of thyrotoxic periodic paralysis

Abstract

Hyperthyroidism rarely cause paralysis by redistributive hypokalemia, with periodic attacks of paralysis termed as thyrotoxic periodic paralysis (TPP). It is more commonly seen in the Asian or Hispanic populations, genetic variation in Kir2.6, a muscle specific thyroid hormone responsive potassium channel cause predisposition of TPP. It typically presents in the early morning with limb weakness. Hyperthyroidism signs and symptoms are need not to be present in all patients. TPP attacks can be triggered by factors such a high-carbohydrate diet, sternous activity, mental stress, and steroids. TPP should be suspected in young patients presenting with acute muscle weakness and severe hypokalemia. Arrhythmias can be noted but most of these will resolve with normalization of potassium.