Hypokalemic Periodic Paralysis Exacerbated by Carbohydrate Load: A Case Report

A 35-year-old male presented with weakness in all four extremities rendering him unable to ambulate. The patient stated the symptoms began after consuming an unknown, large amount of Oreo cookies; thus, a high carbohydrate load likely caused him to exceed the recommended dietary allowance (RDA) of 225-325 grams of carbohydrates per day, depending on one’s daily caloric intake. Lab workup revealed a potassium level of 2.1 mmol/L. Upon potassium replacement, the patient's symptoms improved to baseline, and he was discharged home with follow-up instructions that included a referral for genetic testing. Hypokalemic periodic paralysis (HPP) is a rare condition that, despite having a relatively simple solution for treatment, can lead to an extensive and expensive workup if not considered early on the list of differential diagnoses. Herein, we will discuss the pathophysiology, clinical signs/symptoms, and management of HPP.