2012, Number 1
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Arch Neurocien 2012; 17 (1)
Thyrotoxic hypokalemic periodic paralysis review of the literature on purpose of three cases
Ladino-Malagón LD, Uribe-Uribe CS, Pérez-Villegas DP
Language: Spanish
References: 23
Page: 35-38
PDF size: 80.19 Kb.
ABSTRACT
The hypokalemic periodic paralysis associated with thyrotoxicosis (PPHT) is a rare presentation of hyperthyroidism. It¹2 s a disease prevalent in the asian population, however, is increasingly frequent detection of cases in other parts of the world. We present three cases in a Colombian hospital, three adult male patient in whom periodic paralysis was the mode of presentation of thyroid disease with sudden severe flaccid quadriparesia, they were diagnosed as Graves’ disease, and all were managed successfully with potassium, beta blockers and control of thyroid function. The PPHT is a potentially lethal and reversible medical emergency, requiring management in the emergency department admission and occasionally intensive care unit. Should be suspected in young men with acute paralysis and hypokalemia, and thyroid function should be evaluated In all these cases, early detection and timely treatment change the history of the disease, treatment consists in the management of acute paralysis, and the stabilization of thyroid disease to prevent recurrence.
REFERENCES
Finsterer J. Primary Periodic Paralyses. Acta Neurol Scand 2008;117:145-58.
Venance SL, Cannon SC, Fialho D, Fontaine B, Hanna MG, Ptacek LJ, et al. The primary periodic paralyses, pathogenesis and treatment. Brain 2006; 129:8-17
Ruggieri VL, Arberas CL. Canalopatías hereditarias neuromusculares: miotonías no distróficas, paramiotonías y parálisis periódicas. Rev Neurol 2002; 34 (2):150-6.
Pothiwala P, Levine SN. Thyrotoxic periodic paralysis: a review. J Intensive Care Med 2010;25 (2):71-7.
Kung AW. Clinical Review: thyrotoxic periodic paralysis: a diagnostic challenge. J Clin Endocrinol Metab 2006;91 (7):2490-5.
Puwanant A, Ruff RI. Ina and Ikir are reduced in type 1 hypokalemic and thyrotoxic periodic paralysis. Muscle Nerve 2010;42:315-27.
Devon PR, Dias da Silva MR, Soong TW, Fontaine B, Donaldson MR, Kung AW. Mutations in potassium channel Kir2.6. cause susceptibility to thyrotoxic hypokalemic periodic saralysis. Cell 2010; 140 (8):88-98.
Li J, Yang XB, Zhao Y. Thyrotoxic periodic paralysis in the Chinese population: clinical features in 45 cases. Exp Clin Endocrinol Diabetes 2010;118:22-6.
Ahmed I, Chilimuri SS. Fatal dysrhythmia following potassium replacement for hypokalemic periodic paralysis. West J Emerg Med 2010;11(1):57-9.
Barahona MJ, Vinagre I, Sojo L, Cubero JM, Pérez A. Thyrotoxic periodic paralysis: a case report and literature review. C M& R 2009; 7(3): 96-8.
Lin SH. Thyrotoxic periodic parálisis. Mayo Clin Proc 2005;80 (1):99-105.
Wong P. Hypokalemic thyrotoxic periodic paralysis: a case series. Can J Emerg Med 2003; 5 (5):353-5.
Carod-Artal FJ, Delgado-Villora R. Parálisis periódica tirotóxica. Presentación de dos casos. Rev Neurol 1999; 29 (6):510-2.
Pompeo A, Nepa A, Maddestra M, Feliziani V, Genovesi N. Thyrotoxic hypokalemic periodic paralysis: an overlooked pathology in western countries. Eur J Intern Med 2007;18 (5):380-90.
Neuenschwander P, Carte P, Gonzalez B, Jimenez Z, Merino F. Thyrotoxic hypokalemic periodic paralysis. 18 cases with different forms of thyrotoxicosis. Rev Clin Esp 1995; 195:294-7.
Lin SH, Lin YF, Chen DT, Chu P, Hsu CW, Halperin ML. Laboratory tests to determine the cause of hypokalemia and paralysis. Arch Intern Med 2004; 164:1561-6.
Goldberger ZD. An electrocardiogram triad in thyrotoxic hypokalemic periodic parálisis. Circulation 2007; 115:e179-e80.
Kelley DE, Gharib H, Kennedy FP, Duda RJ, McManis PG. Thyrotoxic periodic paralysis: report of 10 cases and review of electromyographic findings. Arch Intern Med 1989;149:2597-600.
Pérez SS, Pérez-Conde MC. Parálisis periódica hipopotasemica: test de ejercicio. Rev Neurol 2002; 35 (8):738-40.
Soule BR, Simone NL. Hypokalemic periodic paralysis: a case report and review of the literature. Cases Journal 2008;1:256.
Yo TS, Tsen CF, Chuang YY, Yeung LK, Lu KCh. Potassium chloride supplementation alone may not improve hypokalemia in thyrotoxic hypokalemic periodic paralysis. J Emerg Med 2007;32 (3):263-5.
Lu KC, Hsu YJ, Chiu JS, Hsu YD, Lin SH. Effects of potassium supplementation on the recovery of thyrotoxic periodic paralysis. Am J Emerg Med 2004;22 (7):544-7.
Alkaabi JM, Mushtaq A, Al-Maskari FN, Moussa NA, Gariballa S. Hypokalemic periodic paralysis: a case series, review of the literature and update of management. Eur J Emerg Med 2010;17:45-7.