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Thyrotoxic periodic paralysis: a rare cause of periodic paralysis – a case report

Thyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism characterized by episodes of muscle weakness and hypokalemia. Patients may present with a sudden onset of muscle weakness. Though hyperthyroidism occurs more commonly in females, TPP typically occurs in young males in thei...

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Autores principales: Poudel, Rajendra, Baral, Surakshya, Adhikari, Suman, Dhungana, Umesh, Pradhan, Ashesh, Baral, Shankar, Kumal, Kamal, Hamal, Surya B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10129284/
https://www.ncbi.nlm.nih.gov/pubmed/37113937
http://dx.doi.org/10.1097/MS9.0000000000000105
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author Poudel, Rajendra
Baral, Surakshya
Adhikari, Suman
Dhungana, Umesh
Pradhan, Ashesh
Baral, Shankar
Kumal, Kamal
Hamal, Surya B.
author_facet Poudel, Rajendra
Baral, Surakshya
Adhikari, Suman
Dhungana, Umesh
Pradhan, Ashesh
Baral, Shankar
Kumal, Kamal
Hamal, Surya B.
author_sort Poudel, Rajendra
collection PubMed
description Thyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism characterized by episodes of muscle weakness and hypokalemia. Patients may present with a sudden onset of muscle weakness. Though hyperthyroidism occurs more commonly in females, TPP typically occurs in young males in their third decade. CASE PRESENTATION: This is a case of a 32-year-old male who presented to the emergency room with a sudden onset of weakness in bilateral upper and lower limbs, which progressed to complete paralysis in an hour. A provisional diagnosis of hypokalemic periodic paralysis was made and admitted. Later, on further diagnostic workup, the final diagnosis of TPP was made. DISCUSSION: Clinical features of hyperthyroidism in patients with TPP may be subtle. With immediate potassium supplementation, serious cardiopulmonary complications can be prevented and may hasten the recovery of muscle weakness. Nonselective β-adrenergic blockers can lessen and prevent the recurrence of paralytic attacks. CONCLUSION: This case is reported with the objective of generating awareness regarding the clues to the diagnosis, appropriate management, and definitive treatment to a render euthyroid state in order to prevent future recurrence of similar episodes and prevent any complications, and eventually to raise the index of suspicion among treating physicians in cases that present with paralysis in clinical practice.
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spelling pubmed-101292842023-04-26 Thyrotoxic periodic paralysis: a rare cause of periodic paralysis – a case report Poudel, Rajendra Baral, Surakshya Adhikari, Suman Dhungana, Umesh Pradhan, Ashesh Baral, Shankar Kumal, Kamal Hamal, Surya B. Ann Med Surg (Lond) Case Reports Thyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism characterized by episodes of muscle weakness and hypokalemia. Patients may present with a sudden onset of muscle weakness. Though hyperthyroidism occurs more commonly in females, TPP typically occurs in young males in their third decade. CASE PRESENTATION: This is a case of a 32-year-old male who presented to the emergency room with a sudden onset of weakness in bilateral upper and lower limbs, which progressed to complete paralysis in an hour. A provisional diagnosis of hypokalemic periodic paralysis was made and admitted. Later, on further diagnostic workup, the final diagnosis of TPP was made. DISCUSSION: Clinical features of hyperthyroidism in patients with TPP may be subtle. With immediate potassium supplementation, serious cardiopulmonary complications can be prevented and may hasten the recovery of muscle weakness. Nonselective β-adrenergic blockers can lessen and prevent the recurrence of paralytic attacks. CONCLUSION: This case is reported with the objective of generating awareness regarding the clues to the diagnosis, appropriate management, and definitive treatment to a render euthyroid state in order to prevent future recurrence of similar episodes and prevent any complications, and eventually to raise the index of suspicion among treating physicians in cases that present with paralysis in clinical practice. Lippincott Williams & Wilkins 2023-03-25 /pmc/articles/PMC10129284/ /pubmed/37113937 http://dx.doi.org/10.1097/MS9.0000000000000105 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Case Reports
Poudel, Rajendra
Baral, Surakshya
Adhikari, Suman
Dhungana, Umesh
Pradhan, Ashesh
Baral, Shankar
Kumal, Kamal
Hamal, Surya B.
Thyrotoxic periodic paralysis: a rare cause of periodic paralysis – a case report
title Thyrotoxic periodic paralysis: a rare cause of periodic paralysis – a case report
title_full Thyrotoxic periodic paralysis: a rare cause of periodic paralysis – a case report
title_fullStr Thyrotoxic periodic paralysis: a rare cause of periodic paralysis – a case report
title_full_unstemmed Thyrotoxic periodic paralysis: a rare cause of periodic paralysis – a case report
title_short Thyrotoxic periodic paralysis: a rare cause of periodic paralysis – a case report
title_sort thyrotoxic periodic paralysis: a rare cause of periodic paralysis – a case report
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10129284/
https://www.ncbi.nlm.nih.gov/pubmed/37113937
http://dx.doi.org/10.1097/MS9.0000000000000105
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