Thyrotoxic periodic paralysis: a case study and review of the literature

Acute hypokalemic paralysis is a rare cause of acute weakness. Morbidity and mortality associated with unrecognized disease can occur and include respiratory failure and possibly death. Common causes of hypokalemic paralysis include thyrotoxic periodic paralysis (TPP) which is a disorder most frequently seen in Asian males. TPP is characterized by sudden onset of hypokalemia and paralysis that primarily affects the lower extremities. Treatment of TPP includes replacing potassium rapidly, using nonselective beta-blockade and correcting the underlying hyperthyroidism as soon as possible. TPP is curable once euthyroid state is achieved. It is vital for physicians to be able to differentiate TPP from familial hypokalemic periodic paralysis, a more common cause of periodic paralysis in Caucasians and western countries. We describe a 19-year-old Caucasian man who presented with acute onset lower extremity paralysis secondary to acute hypokalemia and was found to have new onset Graves' disease. Abbreviations: TPP: Thyrotoxic periodic paralysis.