The case history and update of current knowledge of thyrotoxic periodic paralysis is presented. [ncbi.nlm.nih.gov]

• Euthyroid

  The PE tests were compared between the hyperthyroid and euthyroid states in five of the TPP and three of the Tw/oPP patients. [ncbi.nlm.nih.gov]

• Vietnamese

  A 23-year-old Vietnamese male presented with a 2-h history of complete flaccid quadriplegia and chest tightness. Electrolyte studies revealed a critical potassium level of 1.4 mmol/L. [ncbi.nlm.nih.gov]

  It occurs predominantly in males of Chinese, Japanese, Vietnamese, Filipino, and Korean descent. TPP is one of several conditions that can cause periodic paralysis. An attack often begins with muscle pain, cramping, and stiffness. [en.wikipedia.org]

  […] disorder with three characteristics which occur at the same time: too much thyroid hormone low levels of potassium in the blood (hypokalemia) muscle weakness or paralysis TPP occurs most often in males of Asian descent, including Japanese, Chinese, Vietnamese [hkpp.org]

  It is most commonly seen in Asian men (Chinese, Vietnamese, Filipino and Koreans). In North America the incidence is 0.1% to 0.2%. [omicsonline.org]

• Noncompliance

  In this case, a 43-year-old African American woman with thyrotoxic periodic paralysis had recurrent lower extremity myopathy and acute respiratory failure precipitated by noncompliance with treatment for Graves disease. [ncbi.nlm.nih.gov]

• Suggestibility

  Given that there is much racial variation in the prevalence of TPP, and the suggestion that non-thyrotoxic periodic paralysis may be more prevalent in Maori, the case highlights the need for more research into the prevalence and pathogenesis of TPP in [ncbi.nlm.nih.gov]

• Hysteria

  Clinicians should include this disease process in their differential diagnoses along with other paralyzing disorders such as Guillain-Barré, multiple sclerosis, transverse myelitis, tick paralysis, conversion disorder or hysteria. [westjem.com]

  […] patients already exhibit signs of hyperthyroidism due to Graves’ disease (goiter and exophthalmia) or thyrotoxicosis symptoms at the time of the paralysis crisis, but often the thyroid alteration is not recognized at the time and may be confused with hysteria [intechopen.com]

  Although patients can present with tetraparesis that resembles other conditions such as Gullain-Barré syndrome, transverse myelitis, and acute spinal cord compression or hysteria, bowel and bladder function are never affected. [dx.doi.org]

• Impulsivity

  Hypokalemia leads to hyperpolarization of muscle cells, making the neuromuscular junction less responsive to normal nerve impulses and leading to decreased contractility of the muscles.It is not clear how the described genetic defects increase the Na [en.wikipedia.org]

  Low potassium levels in the serum lead to hyperpolarization of skeletal muscle cells, making the neuromuscular junction less responsive to normal nerve impulses, which in turn decreases the contractility of the muscles [7]. [cureus.com]

  Cardiovascular examination during this time showed apical impulse at left 6 th intercostal space 0.5 cm lateral to the mid-clavicular line with forceful ill-sustained character. [jnsbm.org]

• Tremor

  Or, there may be signs of hyperthyroidism, such as an enlarged thyroid changes in the eyes, tremor, hair and nail changes. [nlm.nih.gov]

  Case 3 A 32-year-old male presented with acute onset flaccid paraparesis, tremors of both hands and palpitations. He had a history of transient proximal weakness 6 weeks back which recovered spontaneously. [ijem.in]

  They include: Weight loss Palpitations Heat intolerance Increased appetite Agitation Insomnia Hand tremors A fast heart rate Excessive sweating The attack itself normally begins with muscle pain, cramps or muscle stiffness followed by weakness which begins [markvanderpump.co.uk]

  Exercise-related attacks tend to occur during a period of rest immediately after exercise; exercise may therefore be recommended to abort an attack.There may be symptoms of thyroid overactivity, such as weight loss, a fast heart rate, tremor, and perspiration [en.wikipedia.org]

• Flaccid Paralysis of the Lower Extremity

  We herein report a 25-yr-old Korean man who suffered from flaccid paralysis of the lower extremities and numbness of hands. The patient was subsequently diagnosed as having TPP associated with transient thyrotoxicosis due to painless thyroiditis. [ncbi.nlm.nih.gov]

• Fine Tremor

  He had tachycardia, fine tremors of both hands, and grade1 diffuse goiter. His serum potassium was 1.8 mmol/l, ESR 30 mm/h, TSH 0.03 μU/l, free T4:3.2 ng/dl, TPO antibody 117 IU/ml (nl 35), and there was decreased uptake (0.21%) on 99m Tc scan. [ijem.in]

The patient was admitted to the intensive care unit where further workup revealed thyrotoxicosis and the patient was subsequently diagnosed with TPP. [ncbi.nlm.nih.gov]

• Potassium Decreased

  Studies suggest that restoration of potassium levels leads to resolution of paralysis, with potassium decreasing the time to resolution from 13 hours to six hours. 5 However, the physiology of TTP suggests that patients are not truly deficient in potassium [westjem.com]

• Right Bundle Branch Block

  Our patient was found to have an extremely low serum potassium concentration, as well as an electrocardiogram that revealed a prolonged QT interval and right bundle branch block. [ncbi.nlm.nih.gov]

• HLA-A2

  The human leukocyte antigen (HLA) B46, DR9, and DQB1*0303 have been reported to be present at a higher prevalence among Hong Kong Chinese TPP patients, whereas HLA A2, Bw22, AW19, B17, and DRW8 are reported to be associated in Singapore Chinese and Japanese [dx.doi.org]

Treatment includes the supplementation of potassium, a nonselective beta-blocker, and ultimately treatment of the underlying hyperthyroidism. [ncbi.nlm.nih.gov]

The pathophysiology, associations, therapy and prognosis are discussed. It is important that clinicians recognise the condition as all forms of periodic paralysis are amenable to treatment, and progressive weakness can be prevented or even reversed. [ncbi.nlm.nih.gov]

Family history Timing Intensity History of administration of certain drugs Clinical examination Differential Diagnosis Laboratory investigations Serum K CPK and serum myoglobin ECG EMG Nerve conduction studies Provocative Testing Muscle biopsy Treatment Prognosis [slideshare.net]

Severe prognosis in a large family with hypokalemic periodic paralysis. Muscle Nerve 27, 165–169 (2003). 88. Okihiro, M. M. & Nordyke, R. A. Hypokalemic periodic paralysis. Experimental precipitation with sodium liothyronine. [nature.com]

The etiology of these abnormalities and the patient's symptoms was found to be undiagnosed and uncontrolled hyperthyroidism from Grave's disease, which resulted in this dramatic presentation of thyrotoxic hypokalemic paralysis. [ncbi.nlm.nih.gov]

The epidemiology, aetiology and pathogenesis of TPP are discussed. The case demonstrates that neurological examination and biochemical findings may be normal between episodes of paralysis. [ncbi.nlm.nih.gov]

(including hypokalemic periodic paralysis and thyrotoxic periodic paralysis, and other “Channelopathies” or “Membranopathies) Pathophysiology Epidemiology Primary or familial periodic paralysis Secondary periodic paralysis Conventional classification [slideshare.net]

Here we report three cases of TPP in the Netherlands, and review the literature on clinical features, pathophysiological hypothesis and treatment. [ncbi.nlm.nih.gov]

Immediate potassium supplementation prevents serious cardiopulmonary complications and may hasten the recovery of muscle weakness. Nonselective beta-adrenergic blockers can ameliorate and prevent recurrence of the paralytic attacks. [ncbi.nlm.nih.gov]

Treating hyperthyroidism will prevent attacks and may even reverse muscle weakness. [nlm.nih.gov]

Immediate potassium supplementation prevents serious cardiopulmonary complications and may hasten the recovery of muscle weakness. Nonselective β-adrenergic blockers can ameliorate and prevent recurrence of the paralytic attacks. [dx.doi.org]