We discussed a case of a young man who presented to the hospital for chronic, sporadic, episodic BUE and BLE weakness. He also had associated unintentional weight loss, fatigue, and body tremors. He was diagnosed with Thyrotoxic Periodic Paralysis due to Graves’ Disease.
We discussed how to approach weakness (UMN, LMN, NMJ, muscular) as well as the pathophysiology + triggers + treatment of Thyrotoxic Periodic Paralysis.
Thyrotoxic Periodic Paralysis
- Thyrotoxic Periodic Paralysis is a channelopathy that causes intracellular shifts of potassium. Low serum potassium does not reflect a total body potassium deficit.
- Common triggers include: high-carb meals (insulin-mediated), stress (adrenergic state), intense exercise.
- Repletion of potassium should be gradual (~90mEq in 24 hrs) to prevent rebound hyperkalemia.