Hypokalemic Periodic Paralysis

by: Joe Hing Kwok Chu

Other names: familial periodic paralysis, 

periodic paralysis. 　

Hypokalemic periodic paralysis is a congenital

disorder that occurs within certain families and

causes intermittent episodes of muscle weakness

or paralysis. The attacks can occur from daily to

yearly and may last for a few hours or for several

days.  There is a low level of potassium in the

bloodstream (hypokalemia) during the attack. But

the serum potassium levels are normal between attacks.

There is no potassium deficiency in the whole body.

Hypokalemia is low blood levels of potassium (low serum

potassium). 

Alcoholism

Hypokalemic attack may be precipitated by

the administration of oral glucose, 1.5g/kg body weight (up to 100 g)

Intravenous administration of insulin, maximum

0.1 U/kg body weight at 30 and 60 minutes, during

the infusion may aid in precipitating attacks. 

Diet high in sugar (carbohydrates)

Diuretic therapy without potassium chloride

supplementation.

Laxative abuse

Hypomagnesemia

Primary hyper-aldosteronism (Conn's syndrome)

Liver disease with ascites (fluid retention in the

abdomenal area)

Excessive ingestion of licorice (gan cao)

Corticosteroids

Anti inflammatory drugs, indomethacin, phenylbutazone, steroids and sex hormones, particularly estrogens

Conditions associated with hyper-reninemia, in

which an excessive amount of renin introduced into the system causes secondary aldosteronemia.

Crash diets with inadequate intake of potassium

Chronic stress which increases adrenocortical hormone

Chronic diarrhea, mal-absorption syndrome

Perspiration and chronic fever

Renal tubular acidosis - primary

Renal tubular acidosis - secondary to amphotericin B, 

Abuse of Toluene (methylbenzene) or juxtaglomerular drugs  

Apparatus hyperplasia (Bartter's syndrome)

Excess intake of water.

Hypoventilation