Thyrotoxic Periodic Paralysis

Excerpt

Thyrotoxic periodic paralysis (TPP) is an uncommon but dangerous complication seen in thyrotoxic patients. It is characterized by hypokalemia associated with acute proximal symmetrical lower limb weakness and can progress to involve all four limbs and the respiratory musculature. The mechanisms of hypokalemia are incompletely understood. The prevailing theories include increased Na-K ATPase pump activity and mutations in genes encoding Kir channels in skeletal muscle. It is often confused with familial periodic paralysis (FPP) due to the similarity in presentation but can be differentiated based on the presence of thyrotoxic features and biochemical testing. Commonly recorded and described in East Asian males, the incidence of TPP has been rising in the West and other parts of the world. Knowledge regarding identification, early treatment, and prevention of future episodes of TPP is essential in mitigating this potentially lethal complication.