Abstract
Hyperkalemia is a life-threatening dyselectrolytemia that commonly affects cardiac conductivity and contractility. Ascending paralysis affecting the extremities associated with hyperkalemia is not commonly seen. Here we report a case of flaccid quadriparesis in a patient who was taking potassium sparing diuretic for cardiac disease. An electrocardiogram showed typical signs of hyperkalemia. The patient was administered antihyperkalemic measures, which led to a dramatic improvement in symptoms. Hyperkalemic paralysis is a completely reversible emergency condition and should always be considered when dealing with acute onset flaccid paralysis.
Highlights
Hyperkalemia is a frequently encountered clinical problem
When the extracellular potassium increases in hyperkalemia, it blunts the transmission of nerve impulse to muscle fiber[4]
The present case highlights the importance of considering hyperkalemia as a differential diagnosis in patients presenting with acute flaccid paralysis
Summary
Hyperkalemia is a frequently encountered clinical problem. Hyperkalemic paralysis occurs primarily in genetic defects due to sodium channelopathy. The patient did not have any symptom suggestive of cranial nerve involvement, raised intracranial tension and autonomic dysfunction He had a past history of coronary artery disease (anterior wall myocardial infarction with moderate left ventricular dysfunction) and had undergone percutaneous transluminal coronary angioplasty. The patient showed rapid clinical improvement, without the requirement of haemodialysis. He was able to walk on the second day and on examination had grade 5 power in all limbs. An ECG taken after correction of hyperkalemia (after 12 hours of treatment) showed normal sinus rhythm. On follow up after two months the patient was doing well without any neurological symptoms His serum creatinine was 2.4 mg/dl and serum potassium was 4 meq/l.
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