English

Abstract

Background: Acute flaccid motor paralysis is a common neurological emergency with diverse causes and variable outcome. There is paucity of reports documenting the clinical profile of hypokalemia paralysis in neurological practice. AIMS: To study the clinical features, etiology and correlation of hypokalemia with ECG changes and outcome of the subjects with hypokalemic paralysis in a tertiary care teaching hospital in central India. MATERIALS AND METHODS: This study encompassed consecutive subjects with acute flaccid paralysis with hypokalemia from 2009 to 2011. Subjects with Gullain Barre syndrome (GBS), porphyria were excluded. Detailed clinical examination, urine analysis, renal function tests and ECG were carried out. Patients received intravenous or oral potassium supplementation and the underlying causes were treated. STATISTICAL ANALYSIS: The data were analyzed by Fisher exact test, correlation and coefficient test, using EPI Info software. RESULTS: Thirty patients aged 19 to 55 years, including 21 males 09 females were included. Secondary causes such as diarrhea were preset in 23 patients and cause could not be found in 6 patients. All the patients had quadriparesis and (MRC) grade (0 to IV). Deep tendon reflexes were reduced in all patients. Respiratory paralysis occurred in one patient. All patients had potassium levels between patients with severe 0.9 to 3.4mg/L. All patients had ECG change of hypokalemia. More sever hypokalemia needed longer time to recover. One patient died because of respiratory failure. CONCLUSION: Diagnosis of hypokalemic acute paralysis should be considered in any patient presenting with sudden onset, aflexic, pure motor weakness involving one or more limbs without alteration in level of consciousness or sphincter disturbances. It is imperative for physicians, particularly those working in acute care setting, to be aware of this condition.