Thyrotoxic Periodic Paralysis

• Epidemiology: More common among Asian (1.8-8%) and Hispanics (>10 fold as compared with whites) in setting of thyrotoxicosis

• Presentation: Sudden episodes of weakness affecting proximal> distal, LE>UE lasting minutes with decreased tone and DTRs; tachycardia, arrhythmia

• Precipitants: exercise, stress, high carbohydrate intake

• Pathophysiology: unkown but may refect increased Na-K ATPase activity

• Differential Diagnosis: MG, Guillain-Barre, botulinism, tick paralysis, acute myelopathy

• RX:

• KCl 30 mEq q 2hrs with EKG monitor

• Beta-blocker Propanalol 40-120 dialy

• Correction of thyrotoxicosis with thionamides, RIA, or surgery