An unrecognized cause of paralysis in ED: thyrotoxic normokalemic periodic paralysis.

Abstract

Hypokalemic paralysis associated with hyperthyroidism (TPP) is a well-known acute electrolyte and muscle function disorder. Lesser known is normokalemic periodic paralysis associated with hyperthyroidism. We describe two cases of young men with acute muscular paralysis and bilateral impairment of sensation over the lower legs who had normal plasma potassium concentrations. They were initially misdiagnosed as having Guillain-Barré syndrome or hysterical paralysis. However, thyroid function tests showed elevated serum T(3) and T(4) and markedly depressed thyroid-stimulating hormone findings consistent with hyperthyroidism. Control of the hyperthyroidism completely abolished their periodic paralysis. Thyrotoxic normokalemic periodic paralysis (TNPP) should be kept in mind as a cause of acute muscle weakness to avoid missing a treatable and curable condition.

• Authors: Chia-Chao Wu, Tom Chau, Chao-Jiieh Chang, Shih-Hua Lin
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 21 Issue 1 Pg. 71-3 (Jan 2003) ISSN: 0735-6757 [Print] United States
• PMID: 12563586 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright 2003, Elsevier Science (USA). All rights reserved.)

Topics

• Adult
• Diagnosis, Differential
• Guillain-Barre Syndrome (complications, diagnosis, therapy)
• Humans
• Hyperthyroidism (complications, diagnosis, therapy)
• Male
• Paralyses, Familial Periodic (diagnosis, etiology, therapy)