Márquez VOA, Rojas VG, Ramos RM, Cruz CEA, Bierzwinsky SG, Zacarías CR

Language: Spanish
References: 20
Page: 120-125
PDF size: 140.43 Kb.

ABSTRACT

Thyrotoxic hypokalemic periodic paralysis is an acute and reversible episode of muscular weakness associated with a thyrotoxic state. It most commonly occurs in Asiatic patients with Graves’ disease, but it can be seen in any ethnic group. The crises are precipitated by β-adrenergic overstimulation or by hyperinsulinemia, factors associated with hyperactivity of the Na-K ATPase pump, a state that produces an intracellular K+ sequestration. Generally, it manifests itself at night or very early in the morning, commonly after a high-carbohydrate diet or intense physical activity. Proximal muscles of the lower extremities are first affected to later extend to the rest; in serious cases cranial nerves and respiratory muscles can be involved. The clinical episode can be spontaneously resolved in 3 to 36 hours but nevertheless, medical treatment is necessary to prevent lethal complications related to hypokalemia, such as cardiac arrhythmias or respiratory arrest. The definitive control of THPP is obtained by avoiding the precipitating events and by seeking a complete suppressive treatment of the hyperthyroid state. Periodic hypokalemic thyrotoxic paralysis is infrequent in clinical practice and as such is not recognized early during the diagnostic approach. It is important to spread its knowledge to all emergency medical services.

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