Thyrotoxic Periodic Paralysis: A Rare Case

Abstract

Hypokalemic periodic paralysis is a rare hereditary disease characterized by recurrent muscle strength loss.It is a reversibl disease that is clinical presentation with tiredness and paralysis that develops over hours and days.There are precipitative factors such as stress, exercise, carbohydrate-rich nutrition that trigger the formation of episodes. In our study, hypokalemic periodic paralysis was diagnosed as a result of a tetraplegic examination of a patient in our emergency department. Because this case is rare, the literature has been presented with review. A 43-year-old male patient with a known history of lumbar disc hernia was brought to the emergency service of our hospital with the complaint of being unable to move his body when he woke up at 06:00 in the morning. He used 1 oral metamizole sodium 12 hours ago due to headache complaint, and he was fed with high carbohydrate content at dinner. Physical examination revealed a blood pressure of 105/70 mm/hg, a pulse of 93/min, a temperature of 36.8 degrees, a total loss of strength in four extremities, and tetraplegia. Sensory loss, ophthalmopathy, tremor were not detected, pupillary isochoric and light reflex was bilateral, achilles tendon reflex was taken as hypoactive. Eye sizes were normal, thyroid tissue was non-palpable. This case was evaluated as TPP because of the time of onset of attacks, the onset after high-carbohydrate feeding, causing paralysis, improvement of symptoms with replacement, serum potassium, thyroid function tests, and ECG findings. His dramatic response to treatment supported our recognition. In conclusion, it should be considered as a differential diagnosis in young and especially male patients presenting with TPP motor paralysis, which is rare. Determination of thyroid hormones and potassium levels helps in diagnosis.

Keywords

• thyrotoxicosis
• hypokalemic periodic paralysis
• hypokalaemia