Weakness in the Emergency Department: Hypokalemic Periodic Paralysis Induced By Strenuous Physical Activity. Greenlee M, Wingo CS, McDonough AA, Youn JH, Kone BC. PMID: 27336072; PMCID: PMC4910006. Chief Complaint: I had a bout of weakness. Herrmann SM, Textor SC. Although PP is seldom life-threatening, the attacks produce disability and a majority of affected individuals develop persistent, interattack weakness. Moser M. Diuretics and cardiovascular risk factors. Diagnostic criteria for renovascular disease: where are we now?. Daily potassium dosage may need to be much higher than for potassium replacement from simple hypokalemia: 100-150 mEqs of potassium is often needed to manage daily fluctuations in muscle strength and function.Perioperatively, prevention includes avoiding neuromuscular blockade, avoid excessive hyperventilation, warm the patient, provide adequate hydration, avoid glucose infusions, do not give diuretics, and closely monitor the electrocardiogram for signs of hypokalemia.

Serum potassium and clinical outcomes in the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS). Rapidly absorbed boluses of liquid potassium are generally needed to abort an attack, but some patients also find positive maintenance results with time-released potassium tablets. We report a case of a 45-year-old male patient with thyrotoxicosis complicated with quadriparesis. Nilsson E, Gasparini A, Ärnlöv J, Xu H, Henriksson KM, Coresh J, et al. Genetic linkage between histocompatibility antigens (HLA) and a new syndrome of familial hypokalemia. Overactivity, a diet that is not low in sodium and carbohydrates, or simply an unfortunate gene mutation can lead to a type of chronic, low level weakness called an "abortive attack," or to permanent muscle damage.

Al-Momen A, El-Mogy I. Intragastric balloon for obesity: a retrospective evaluation of tolerance and efficacy. This test measures the amplitude of a nerve response (called the Compound Muscle Action Potential or CMAP) for 40 to 50 minutes following a few minutes of exercise. Endocrine and Metabolic Manifestations of Invasive Fungal Infections and Systemic Antifungal Treatment. 2016 Mar 2;15(2):93-5. doi: 10.5505/1304.7361.2015.57984. Common Characteristics Associated with the Periodic Paralyses Mutations have been identified in In patients with mutations in SCN4A or CACNA1S, therefore, the channel has a reduced excitability and signals from the central nervous system are unable to depolarise the muscle. Marill KA, Miller ES. Normal saline is the preferred IV solution for patients with familial hypokalemic periodic paralysis. Zacchia M, Abategiovanni ML, Stratigis S, Capasso G. Potassium: From Physiology to Clinical Implications. Pathogenesis of hypokalemia in autosomal dominant hypocalcemia type 1. Those with unclear diagnoses are often more sick, many times with cardiac symptoms during attacks, such that the challenge tests are disfavored unless absolutely necessary. Abortive attacks often respond to extra potassium, cutting carbohydrates, getting plenty of rest, increasing doses of medication and gentle daily exercise such as short walks.

Coentre R, Saraiva R, Levy P. First-Episode Psychosis and Hypokalemia: A Case Report and Review of the Literature. Hyperkalemic periodic paralysis causes episodes of extreme muscle weakness, with attacks often beginning in childhood.Some people with hyperkalemic periodic paralysis have increased levels of potassium in their blood (In humans, the most common underlying genetic cause is one of several possible Mutations altering the usual structure and function of this sodium channel therefore disrupt regulation of muscle contraction, leading to episodes of severe muscle weakness or paralysis. Perazella MA, Brown E. Electrolyte and acid-base disorders associated with AIDS: an etiologic review. Sitprija V. Altered fluid, electrolyte and mineral status in tropical disease, with an emphasis on malaria and leptospirosis.

Avoiding carbohydrate-rich meals, strenuous exercise and other identified triggers, and taking Paralysis attacks can be managed by drinking one of various potassium salts dissolved in water (debate exists over which, if any one in particular, is best used, but potassium chloride and bicarbonate are common). de Wijkerslooth LR, Koch BC, Malingre MM, et al. Episodes frequently involve varying degrees of paralysis.
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Mutations in the chloride channel gene CLCNKB as a cause of classic Bartter syndrome. Hypokalemia in women and methadone therapy are the strongest non-cardiologic factors associated with QT prolongation in an emergency department setting. Hypokalemic periodic paralysis types 1 and 2 are caused by mutations in the CACNL1A3 and SCN4A genes, respectively, and are both inherited in … Molecular Basis of Hypokalemia-Induced Ventricular Fibrillation. Kamiyoshi N, Nozu K, Urahama Y, Matsunoshita N, Yamamura T, Minamikawa S, et al.

For the disease in equines, see

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