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CASE REPORT
Paralysis that easily reverses: a case of thyrotoxic periodic paralysis
  1. Niranjan Tachamo1,
  2. Saroj Lohani2,
  3. Salik Nazir2,
  4. Noelle Juliano1
  1. 1Department of Internal Medicine, Reading Health System, West Reading, Pennsylvania, USA
  2. 2Reading Hospital and Medical Center, Reading, Pennsylvania, USA
  1. Correspondence to Dr Niranjan Tachamo, niranjantachamo{at}gmail.com

Summary

Thyrotoxic periodic paralysis is a potentially life-threatening condition associated with recurrent episodes of muscle weakness and hypokalaemia due to hyperthyroidism. Diagnosis is often delayed or misdiagnosed due to its rarity in the western world and subtle features of hyperthyroidism on initial presentation. Here we present the case of a 25-year-old man who presented to the emergency department (ED) with sudden onset weakness of bilateral upper and lower extremities. His labs revealed hypokalaemia with elevated T4 and suppressed thyroid-stimulating hormone and he was diagnosed with thyrotoxic periodic paralysis. He was treated with potassium repletion, atenolol and methimazole with complete reversal of his paralysis within the next day. Unfortunately, he failed to keep the follow-up appointment after discharge, ran out of his methimazole and landed up in the ED again.

https://doi.org/10.1136/bcr-2016-218951

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    Footnotes

    • Contributors NT contributed by writing bulk of the case report. He also participated in concept, presentation style and literature search. SL wrote part of the case presentation. He also gave valuable feedback on the initial draft and carried out some major corrections. SN participated in discussing and planning of the case report format and presentation style. He also helped to carry out literature search and also edited the manuscript before submission. NJ proofread the original draft and gave feedback and carried out corrections including typographical errors. NJ was also part of the patient care team.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.