Physicians & Patients Library

Welcome to the Physician & Patient Library
One of the core missions of Periodic Paralysis International is to serve as a trusted documentation
resource for all aspects of Periodic Paralysis. This library brings together materials created for both
patients and health care providers, along with carefully selected links to outside resources.
This is an ongoing project, designed to grow and evolve for many years to come. While we are just
getting started, new material will continue to be added on a regular basis. Our goal is to provide a
comprehensive, reliable, and accessible source of information to support both medical professionals
and the PP community.

Disclaimer
The resources in this library are provided for informational purposes only. Periodic Paralysis
International does not guarantee the accuracy or completeness of this material. Content should not
be used as a substitute for professional medical advice, diagnosis, or treatment. Always consult your
physician or qualified health care provider regarding any medical questions or concerns.

Physician’s Summary: Hypokalemic Periodic Paralysis

Hypokalemic – Basic Reading

Hyperkalemic PP Medications

Hyperkalemic – Medications

*A Diagnostic Flowchart for Diagnosing Hypokalemic Periodic Paralysis

Hypokalemic – Forms & Charts

*Starting Acetazolamide (Diamox)

Hypokalemic – Medications

*Andersen-Tawil Syndrome FAQ

Andersen-Tawil – Basic Reading

*Hospital Management Guidelines – ATS

Andersen-Tawil – Forms & Charts

*Andersen-Tawil Syndrome

Andersen-Tawil – Basic Reading

*Paramyotonia Congenita

Paramyotonia – Basic Reading

*Paramyotonia Congenita FAQ

Paramyotonia – Basic Reading

*Hyperkalemic PP and Paramyotonia Congenita

Hyperkalemic – Journal Articles

*Hyperkalemic Periodic Paralysis FAQ

Hyperkalemic – Basic Reading

*GUIDELINES ved indlaeggelse for Hypokalemisk Periodika Paralyse Patient

Hypokalemic – Forms & Charts

*Hospital Management Guidelines – HypoKPP

Hypokalemic – Forms & Charts

*Determining the Origin of Hypokalemic Paralysis

Hypokalemic – Forms & Charts

*Hypokalemic Periodic Paralysis

Hypokalemic – Basic Reading

*Hypokalemic Periodic Paralysis FAQ

Hypokalemic – Basic Reading

*Hospital Management Guidelines for Thyrotoxic Hypokalemic Paralysis

Thyrotoxic – Forms & Charts

*The Man Who Couldn’t Walk

Thyrotoxic – Journal Articles

*Thyrotoxic Hypokalemic Periodic Paralysis – A Physicians Summary

Thyrotoxic – Journal Articles

*Thyrotoxic HypoKPP FAQs for Patients

Thyrotoxic – Basic Reading

*The ‘CMAP’ Compound Muscle Action Potential Test

Journal Articles / Scientific Papers

*Akut behandling af et hypokalemisk paralytisk anfald

Hypokalemic – Emergency Care

*Anesthesia in Hypokalemic Periodic Paralysis

Hypokalemic – Emergency Care

*Emergency Treatment for a Hypokalemic Paralytic Attack

Hypokalemic – Emergency Care

*Emergency Care HyperKPP & PMC

Hyperkalemic – Emergency Care

*Emergency Treatment of Andersen-Tawil Syndrome

Andersen-Tawil – Emergency Care

*Emergency Treatment of Thyrotoxic Hypokalemic Periodic Paralysis

Thyrotoxic – Emergency Care

Thyrotoxic Hypokalemic Periodic Paralysis

Thyrotoxic Thyrotoxic – Basic Reading

Paramyotonia Congenita & Paramyotonia Syndromes

Paramyotonia Paramyotonia – Basic Reading

Focal and abnormally persistent paralysis associated with congenital paramyotonia

Paramyotonia Paramyotonia – Children

Rare Disorder Groups Are Vital To Physicians

Andersen-Tawil Andersen-Tawil – Journal Articles Hyperkalemic Hyperkalemic – Journal Articles Hypokalemic Hypokalemic – Journal Articles Other Resources Other Resources – Journal Articles

Links out – Diagnosis and Management Information

Andersen-Tawil Andersen-Tawil – Diagnosis Andersen-Tawil – Management Hyperkalemic Hyperkalemic – Diagnosis Hyperkalemic – Management Hypokalemic Hypokalemic – Diagnosis Hypokalemic – Management Other Resources Other Resources – Journal Articles

Long-time exercise test in the diagnosis of periodic paralysis

Andersen-Tawil Andersen-Tawil – Diagnosis Hyperkalemic Hyperkalemic – Diagnosis Hypokalemic Hypokalemic – Diagnosis

Pregnancy and Birth in HypoKPP

Hypokalemic Hypokalemic – Children Hypokalemic – Surveys

The Life and Death of Aleksandr Batutenko

Hypokalemic Hypokalemic – Story

Management Strategies For Hypokalemic Periodic Paralysis

Hypokalemic Hypokalemic – Management

Did Elizabeth Barrett Browning Have Hypokalemic Periodic Paralysis?

Hypokalemic Hypokalemic – Journal Articles

Bumetanide potential treatment for HypoKPP

Hypokalemic Hypokalemic – Journal Articles Hypokalemic – Medications

Dichlorphenamide: A Review in Primary Periodic Paralyses.

Andersen-Tawil Andersen-Tawil – Journal Articles Hyperkalemic Hyperkalemic – Journal Articles Hypokalemic Hypokalemic – Journal Articles

GUIDELINES ved indlæggelse for Hypokalemisk Periodika Paralyse Patient

Hypokalemic Hypokalemic – Management

Colonoscopy Prep Protocol for Patient with Hypokalemic Periodic Paralysis

Hypokalemic Hypokalemic – Emergency Care Hypokalemic – Management

Severe respiratory phenotype in a patient with HypoKPP

Hypokalemic Hypokalemic – Emergency Care Hypokalemic – Journal Articles

The Abortive Attack – Weakness Between Attacks

Hypokalemic Hypokalemic – Basic Reading Paramyotonia Paramyotonia – Basic Reading

A Quick Overview of Hypokalemic Periodic Paralysis

Hypokalemic Hypokalemic – Basic Reading Hypokalemic – Diagnosis Hypokalemic – Emergency Care

Pregnancy and Birth in Hyperkalemic PP

Hyperkalemic Hyperkalemic – Surveys Paramyotonia Paramyotonia – Surveys

Malignant Hyperthermia and HyperKPP/PMC

Hyperkalemic Hyperkalemic – Emergency Care Paramyotonia Paramyotonia – Emergency Care

Diet for Patients with HyperKPP and PMC

Hyperkalemic Hyperkalemic – Diet Paramyotonia Paramyotonia – Diet

Summary of Hyperkalemic Periodic Paralysis

Hyperkalemic Hyperkalemic – Basic Reading Hyperkalemic – Management

Meet Our Patients

Hypokalemic Hypokalemic – Coping Hypokalemic – Story

Pregnancy and Birth in HypoKPP

Children's Issues Children's Issues – Children Children's Issues – Surveys Hypokalemic Hypokalemic – Children Hypokalemic – Surveys

Pregnancy and Birth in Hyperkalemic PP

Children's Issues Children's Issues – Surveys Hyperkalemic Hyperkalemic – Children Hyperkalemic – Surveys Paramyotonia Paramyotonia – Children Paramyotonia – Surveys

Meal Plan Template

Andersen-Tawil Andersen-Tawil – Diet Hyperkalemic Hyperkalemic – Diet Hypokalemic Hypokalemic – Diet Normokalemic Normokalemic – Diet Other Resources Other Resources – Diet Paramyotonia Paramyotonia – Diet Thyrotoxic Thyrotoxic – Diet

Role of Potassium in Maintaining Health

Andersen-Tawil Andersen-Tawil – Diet Hyperkalemic Hyperkalemic – Diet Hypokalemic Hypokalemic – Diet Normokalemic Normokalemic – Diet Other Resources Other Resources – Diet Paramyotonia Paramyotonia – Diet Thyrotoxic Thyrotoxic – Diet

Pain in the Periodic Paralyses

Andersen-Tawil Andersen-Tawil – Surveys Children's Issues Children's Issues – Surveys Hyperkalemic Hyperkalemic – Surveys Hypokalemic Hypokalemic – Surveys Normokalemic Paramyotonia Paramyotonia – Surveys Scientific Thyrotoxic Thyrotoxic – Surveys

Myoclonus Survey Part 2

Andersen-Tawil Andersen-Tawil – Surveys Hyperkalemic Hyperkalemic – Surveys Hypokalemic Hypokalemic – Surveys Paramyotonia Paramyotonia – Surveys

Myoclonus Survey in Periodic Paralysis Patients Part 1

Andersen-Tawil Andersen-Tawil – Surveys Hyperkalemic Hyperkalemic – Surveys Hypokalemic Hypokalemic – Surveys Normokalemic Paramyotonia Paramyotonia – Surveys Scientific

Pregnancy and Birth in the Periodic Paralysis Patient

Andersen-Tawil Andersen-Tawil – Children Andersen-Tawil – Surveys Children's Issues Children's Issues – Children Children's Issues – Surveys Hyperkalemic Hyperkalemic – Children Hyperkalemic – Surveys Hypokalemic Hypokalemic – Children Hypokalemic – Surveys Normokalemic Paramyotonia Paramyotonia – Children Paramyotonia – Surveys

Survey of 64 Periodic Paralyses Patients

Andersen-Tawil Andersen-Tawil – Surveys Hyperkalemic Hyperkalemic – Surveys Hypokalemic Hypokalemic – Surveys Normokalemic Paramyotonia Paramyotonia – Surveys Thyrotoxic Thyrotoxic – Surveys

Pregnancy and Birth in Andersen-Tawil Syndrome

Andersen-Tawil Andersen-Tawil – Surveys Children's Issues Children's Issues – Children Children's Issues – Surveys

Physician’s Sheet: Acetazolamide Drug Interactions

Andersen-Tawil Andersen-Tawil – Medications Hyperkalemic Hyperkalemic – Medications Hypokalemic Hypokalemic – Medications Normokalemic Normokalemic – Medications Other Resources Other Resources – Journal Articles Paramyotonia Paramyotonia – Medications Scientific

The Use of Bactrim in the Periodic Paralyses

Andersen-Tawil Andersen-Tawil – Management Andersen-Tawil – Medications Hyperkalemic Hyperkalemic – Management Hyperkalemic – Medications Hypokalemic Hypokalemic – Management Hypokalemic – Medications Normokalemic Normokalemic – Management Normokalemic – Medications Paramyotonia Paramyotonia – Management Paramyotonia – Medications Thyrotoxic Thyrotoxic – Management Thyrotoxic – Medications

Sleep Complaints in Periodic Paralysis

Andersen-Tawil Andersen-Tawil – Journal Articles Hyperkalemic Hyperkalemic – Journal Articles Hypokalemic Hypokalemic – Journal Articles Normokalemic Normokalemic – Journal Articles Other Resources Other Resources – Journal Articles Paramyotonia Paramyotonia – Journal Articles Scientific Thyrotoxic Thyrotoxic – Journal Articles

Physician’s Reading Room

Andersen-Tawil Andersen-Tawil – Journal Articles Hyperkalemic Hyperkalemic – Journal Articles Hypokalemic Hypokalemic – Journal Articles Normokalemic Normokalemic – Journal Articles Other Resources Other Resources – Journal Articles Paramyotonia Paramyotonia – Journal Articles Scientific Thyrotoxic Thyrotoxic – Journal Articles

New Findings Suggest Genetics Behind Drug Response

Andersen-Tawil Andersen-Tawil – Journal Articles Andersen-Tawil – Medications Hyperkalemic Hyperkalemic – Journal Articles Hyperkalemic – Medications Hypokalemic Hypokalemic – Journal Articles Hypokalemic – Medications Normokalemic Normokalemic – Journal Articles Normokalemic – Medications Other Resources – Journal Articles Paramyotonia Paramyotonia – Journal Articles Paramyotonia – Medications Scientific Thyrotoxic Thyrotoxic – Journal Articles Thyrotoxic – Medications

Leaky Channels make weak muscles

Andersen-Tawil Andersen-Tawil – Journal Articles Hypokalemic Hypokalemic – Journal Articles Paramyotonia Paramyotonia – Journal Articles Scientific Thyrotoxic Thyrotoxic – Journal Articles

Physician’s Information: Local Anaesthesia

Andersen-Tawil Andersen-Tawil – Emergency Care Children's Issues Children's Issues – Emergency Care Hyperkalemic Hyperkalemic – Emergency Care Hypokalemic Hypokalemic – Emergency Care Normokalemic Normokalemic – Emergency Care Paramyotonia Paramyotonia – Emergency Care Scientific Thyrotoxic Thyrotoxic – Emergency Care

Malignant Hyperthermia

Andersen-Tawil Andersen-Tawil – Emergency Care Children's Issues Children's Issues – Emergency Care Hyperkalemic Hyperkalemic – Emergency Care Hypokalemic Hypokalemic – Emergency Care Normokalemic Normokalemic – Emergency Care Paramyotonia Paramyotonia – Emergency Care Thyrotoxic Thyrotoxic – Emergency Care

Tracking Triggers – Food and Beverage Chart

Andersen-Tawil Andersen-Tawil – Diet Hypokalemic Hypokalemic – Diet

Low Sodium, Low Carb Ideas for Hypokalemic Periodic Paralysis

Andersen-Tawil Andersen-Tawil – Diet Hypokalemic Hypokalemic – Diet

Diet for Patients with Hypokalemic Periodic Paralysis

Andersen-Tawil Andersen-Tawil – Diet Hypokalemic Hypokalemic – Diet Thyrotoxic Thyrotoxic – Diet

The Potassium Draw: Special Measures

Andersen-Tawil Andersen-Tawil – Diagnosis Hyperkalemic Hyperkalemic – Diagnosis Hypokalemic Hypokalemic – Diagnosis Normokalemic Normokalemic – Diagnosis Paramyotonia Paramyotonia – Diagnosis Thyrotoxic Thyrotoxic – Diagnosis

Chart Comparing Periodic Paralyses

Andersen-Tawil Andersen-Tawil – Diagnosis Andersen-Tawil – Forms & Charts Children's Issues Hyperkalemic Hyperkalemic – Diagnosis Hypokalemic Hypokalemic – Diagnosis Normokalemic Normokalemic – Diagnosis Paramyotonia Paramyotonia – Diagnosis Thyrotoxic Thyrotoxic – Diagnosis

How is periodic paralysis diagnosed?

Andersen-Tawil Andersen-Tawil – Diagnosis Hyperkalemic Hyperkalemic – Diagnosis Hypokalemic Hypokalemic – Diagnosis Normokalemic Normokalemic – Diagnosis Paramyotonia Paramyotonia – Diagnosis Thyrotoxic Thyrotoxic – Diagnosis

Periodic Paralysis and the New Mother

Andersen-Tawil Andersen-Tawil – Children Hyperkalemic Hyperkalemic – Children Hypokalemic Hypokalemic – Children Normokalemic Paramyotonia Paramyotonia – Children Thyrotoxic

Anaesthesia and peri-operative care in the primary Periodic Paralysis Disorders

Andersen-Tawil Andersen-Tawil – Basic Reading Andersen-Tawil – Emergency Care Andersen-Tawil – Management Hyperkalemic Hyperkalemic – Basic Reading Hyperkalemic – Emergency Care Hyperkalemic – Management Hypokalemic Hypokalemic – Basic Reading Hypokalemic – Emergency Care Hypokalemic – Management Normokalemic Normokalemic – Basic Reading Normokalemic – Emergency Care Normokalemic – Management Paramyotonia Paramyotonia – Basic Reading Paramyotonia – Emergency Care Paramyotonia – Management Thyrotoxic Thyrotoxic – Basic Reading Thyrotoxic – Emergency Care Thyrotoxic – Management

Measuring quality of life impairment in periodic paralyses

Andersen-Tawil Andersen-Tawil – Basic Reading Andersen-Tawil – Journal Articles Andersen-Tawil – Management Hyperkalemic Hyperkalemic – Basic Reading Hyperkalemic – Journal Articles Hyperkalemic – Management Hypokalemic Hypokalemic – Basic Reading Hypokalemic – Journal Articles Hypokalemic – Management Normokalemic Normokalemic – Basic Reading Normokalemic – Journal Articles Normokalemic – Management Paramyotonia Paramyotonia – Basic Reading Paramyotonia – Journal Articles Paramyotonia – Management Thyrotoxic Thyrotoxic – Basic Reading Thyrotoxic – Journal Articles Thyrotoxic – Management

Comparison of Five Forms of Periodic Paralysis

Andersen-Tawil Andersen-Tawil – Basic Reading Hyperkalemic Hyperkalemic – Basic Reading Hypokalemic Hypokalemic – Basic Reading Normokalemic Normokalemic – Basic Reading Paramyotonia Paramyotonia – Basic Reading Thyrotoxic Thyrotoxic – Basic Reading

How to Determine What Triggers Attacks of Periodic Paralysis

Andersen-Tawil Andersen-Tawil – Diagnosis Andersen-Tawil – Diet Hyperkalemic Hyperkalemic – Diagnosis Hyperkalemic – Diet Hypokalemic Hypokalemic – Diagnosis Hypokalemic – Diet Normokalemic Normokalemic – Diagnosis Normokalemic – Diet Other Resources – Diet Paramyotonia Paramyotonia – Diagnosis Paramyotonia – Diet Thyrotoxic Thyrotoxic – Diagnosis Thyrotoxic – Diet

Physician’s Summary: Andersen-Tawil Syndrome

Andersen-Tawil Andersen-Tawil – Basic Reading Andersen-Tawil – Emergency Care Scientific

Andersen-Tawil Syndrome FAQ

Andersen-Tawil Andersen-Tawil – Basic Reading

Potassium Supplementation and B-12 Deficiency

Andersen-Tawil Andersen-Tawil – Basic Reading Hypokalemic Thyrotoxic

Anesthesia and Peri-Operative Care in the primary Periodic Paralysis Disorders. Part 1: A Review of the Literature

Andersen-Tawil Andersen-Tawil – Basic Reading Andersen-Tawil – Emergency Care Andersen-Tawil – Management Hyperkalemic Hyperkalemic – Basic Reading Hyperkalemic – Emergency Care Hyperkalemic – Management Hypokalemic Hypokalemic – Basic Reading Hypokalemic – Emergency Care Hypokalemic – Management Normokalemic Normokalemic – Basic Reading Normokalemic – Emergency Care Normokalemic – Management Paramyotonia Paramyotonia – Emergency Care Paramyotonia – Management Scientific Thyrotoxic Thyrotoxic – Basic Reading Thyrotoxic – Emergency Care Thyrotoxic – Management

Anesthesia and Peri-Operative Care in the primary Periodic Paralysis Disorders. PART 2: Practical Guidelines

Andersen-Tawil Andersen-Tawil – Basic Reading Andersen-Tawil – Emergency Care Andersen-Tawil – Management Hyperkalemic Hyperkalemic – Basic Reading Hyperkalemic – Emergency Care Hyperkalemic – Management Hypokalemic Hypokalemic – Basic Reading Hypokalemic – Emergency Care Hypokalemic – Management Normokalemic Normokalemic – Basic Reading Normokalemic – Emergency Care Normokalemic – Management Paramyotonia Paramyotonia – Basic Reading Paramyotonia – Emergency Care Paramyotonia – Management Scientific Thyrotoxic Thyrotoxic – Basic Reading Thyrotoxic – Emergency Care Thyrotoxic – Management

Anesthesia for the PEDIATRIC Patient with Hypokalemic Periodic Paralysis

Dr. Harr has researched and compiled safe anesthesia guidelines for the anesthesia provider and condensed everything into an easy to read one-page Quick Reference Guide. This valuable resource is available to patients and medical experts in a downloadable format. Information in this guide pertains to the PEDIATRIC Hypokalemic Periodic Patient.
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Anesthesia for the ADULT Patient with Hypokalemic Periodic Paralysis

Dr. Harr has researched and compiled safe anesthesia guidelines for the anesthesia provider and condensed everything into an easy to read one-page Quick Reference Guide. This valuable resource is available to patients and medical experts in a downloadable format. Information in this guide pertains to the ADULT Hypokalemic Periodic Patient.
Read More

Anesthesia and Peri-Operative Care in the primary Periodic Paralysis Disorders. Part 1: A Review of the Literature

Annabelle SJ Baughan [1] MB FRCP FRCPath,Deborah Cavel-Greant [1],Janice Megalo [1] AAS-MAA, andFrank Weber [2]…
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Anesthesia and Peri-Operative Care in the primary Periodic Paralysis Disorders. PART 2: Practical Guidelines

Annabelle SJ Baughan [1] MB FRCP FRCPath,Deborah Cavel-Greant [1],Janice Megalo [1] AAS-MAA, andFrank Weber [2]…
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Practical aspects in the
management of hypokalemic periodic paralysis

Management considerations in hypokalemic periodic paralysis include accurate diagnosis, potassium dosage for acute attacks, choice of diuretic for prophylaxis, identification of triggers, creating a safe physical environment, peri-operative measures, and issues in pregnancy. A positive genetic test in the context of symptoms is the gold standard for diagnosis. Potassium chloride is the favored potassium salt given at 0.5-1.0 mEq/kg for acute attacks. The oral route is favored, but if necessary, a mannitol solvent can be used for intravenous administration. Avoidance of or potassium prophylaxis for common triggers, such as rest after exercise, high carbohydrate meals, and sodium, can prevent attacks. Chronically, acetazolamide, dichlorphenamide, or potassium-sparing diuretics decrease attack frequency and severity but are of little value acutely. Potassium, water, and a telephone should always be at a patient’s bedside, regardless of the presence of weakness. Perioperatively, the patient’s clinical status should be checked frequently. Firm data on the management of periodic paralysis during pregnancy is lacking. Patient support can be found at http://www.periodicparalysis.org.

Read the full article here

Characterization of hyperkalemic periodic paralysis: a survey of genetically diagnosed individuals

This exploratory study aims to create an evidence-based comprehensive characterization of hyperkalemic periodic paralysis (hyperPP). HyperPP is a rare genetic disorder that causes episodes of flaccid paralysis. Disease descriptions in the literature are based upon isolated clinical encounters and case reports. We describe the experience of a large cohort of genetically diagnosed individuals with hyperPP. We surveyed genetically characterized individuals age 18 and over to assess disease comorbidities, diagnostic testing, management, and quality of life issues relevant to hyperPP. Myotonia was reported by 55.8 % of subjects and paramyotonia by 45.3 %. There is a relative risk of 3.6 (p < 0.0001) for thyroid dysfunction compared to the general population. Twenty-five percent of subjects experienced their sentinel attack in the second decade of life. It took an average of 19.4 years and visits to four physicians to arrive at the diagnosis of hyperPP. In addition to limbs and hands being affected during attacks, 26.1 % of subjects reported their breathing musculature was affected and 62.0 % reported their facial muscles were affected. There was a lifelong trend of increasing attack frequency, which was particularly common during childhood and adolescence. Approximately one-third of individuals experienced progressive myopathy. Permanent muscle weakness was evident and worsened during childhood and after age 40. Those with no chronic treatment regimen have a RR of 2.3 for inadequate disease control compared to those taking long-term medications. This study revealed a multitude of heretofore unidentified characteristics of hyperPP, in addition to providing a different perspective on some previously held notions regarding the condition.

Read the full article here