HYPOKALEMIC PERIODIC

PARALYSIS
 OVERVIEW

• Hypokalemic periodic paralysis (hypoPP) is a disorder that causes occasional

episodes of muscle weakness and sometimes a lower than normal level of
potassium in the blood. The medical name for low potassium level is
hypokalemia.
• HypoPP is one of a group of genetic disorders that includes
hyperkalemic periodic paralysis and thyrotoxic periodic paralysis.
• HypoPP is the most common form of periodic paralysis. It affects males more
often.
 CAUSES

• HypoPP is congenital. This means it is present at birth. In most cases, it is passed

down through families (inherited) as an autosomal dominant disorder. In other words,
only one parent needs to pass the gene related to this condition on to their child in
order for the child to be affected.
• In some cases, the condition may be the result of a genetic problem that is not
inherited.
• Unlike other forms of periodic paralysis, people with hypoPP have normal thyroid
function. But they have a very low blood level of potassium during episodes of
weakness. This results from potassium moving from the blood into muscle cells in an
abnormal way.
• Risk factors include having other family members with periodic paralysis. The risk is
slightly higher in Asian men who also have thyroid disorders.
 SYMPTOMS

• Symptoms include attacks of muscle weakness or loss of muscle movement (paralysis) that come and go.
There is normal muscle strength between attacks.
• Attacks usually begin in the teen years, but they can occur before age 10. How often the attacks occur varies.
Some people have attacks every day. Others have them once a year. During attacks the person remains alert.
The weakness or paralysis:
• Most commonly occurs at the shoulders and hips
• May also affect the arms, legs, muscles of the eyes, and muscles that help with breathing and swallowing
• Occurs on and off
• Most commonly occurs on awakening or after sleep or rest
• Is rare during exercise, but may be triggered by resting after exercise
• May be triggered by high-carbohydrate, high-salt meals, stress, pregnancy, heavy exercise, and cold
• An attack usually lasts for several hours up to a day
 EXAMS AND TESTS

• The health care provider may suspect hypoPP based on a family Tests that may be done include:
history of the disorder. Other clues to the disorder are muscle
weakness symptoms that come and go with normal or low results of • Electrocardiogram (ECG), which may be abnormal
a potassium test.
during attacks
• Between attacks, a physical examination shows nothing abnormal.
Before an attack, there may be leg stiffness or heaviness in the legs. • Electromyography (EMG), which is usually normal
• During an attack of muscle weakness, blood potassium level is low. between attacks and abnormal during attacks
This confirms the diagnosis. There is no decrease in total body
potassium. Blood potassium level is normal between attacks. • Muscle biopsy, which may show abnormalities
• During an attack, muscle reflexes are decreased or absent. And • Other tests may be ordered to rule out other causes.
muscles go limp rather than staying stiff. Muscle groups near the
body, such as the shoulders and hips, are involved more often than
the arms and legs.
ECG OF A HYPOKALEMIA
 TREATMENT

• The goals of treatment are relief of symptoms and prevention of further attacks.
• Muscle weakness that involves the breathing or swallowing muscles is an emergency situation.
Dangerous irregular heartbeats (heart arrhythmias) may also occur during attacks. Any of these
must be treated right away.
• Potassium given during an attack may stop the attack. Potassium can be taken by mouth. But if
weakness is severe, potassium may need to be given through a vein (IV).
• Taking potassium supplements may help prevent muscle weakness.
• Eating a low-carbohydrate diet may help decrease symptoms.
• A medicine called acetazolamide may be prescribed to prevent attacks. Your provider may tell you
to also take potassium supplements because acetazolamide may cause your body to lose potassium.
• If acetazolamide does not work for you, other medicines may be prescribed.