Doctor

Clinical Synopsis

Thyrotoxic periodic paralysis (THKPP) is an uncommon disorder characterized by simultaneous thyrotoxicosis, hypokalemia, and paralysis that occurs primarily in males of Asian descent, including patients of Japanese, Chinese, Vietnamese, Korean and Filipino ancestry.

I am not my body!

People with Hypokalemic periodic paralysis, and some Andersen-Tawil Syndrome patients, need to eat a diet low in carbohydrates and sodium, since both carbohydrates and sodium trigger attacks. But how do you do it? Here are handy tips on how to plan a diet that is reduced in sodium and carbohydrates.

Tips on Reducing Sodium

At Home

Use this chart to help determine patterns to your food triggers. Blanks have been left for you to individualize the chart to your needs. Check food labels for sodium content, etc. This chart is intended to be utilized as an adjunct to a food journal.

This chart allows comparison of the forms of primary periodic paralysis, symptoms, clinical and cardiac signs, effect of potassium, triggers and therapies. 

Introduction:

The major features found in all the periodic paralyses are:

1. Attacks almost always begin before the age of 25, though occasionally later in life. ATS patients can develop first symptoms at any age.

2. Serum potassium fluctuates shortly before an attack, but serum potassium level will normalize before the attacks resolves and will be within the normal range between attacks. This is not a disorder of the blood but one in which there is an inappropriate shift of fluid, K+ and NA+ during attacks. 

When evaluating patients for periodic paralysis it is vital to obtain accurate results from blood draws. Because potassium levels which vary only a fraction of a point may be enough to trigger weakness in some patients, the lab may need to be made aware of specialized procedures which should ideally be used to obtain samples for K+ evaluation.

From "A Manual of Laboratory Diagnostic Tests" by Frances Fischbach, Page 247-253.

Potassium (K+) Normal Values: 3.5-5.0 mmol/liter 4.0-4.7 mmol/liter (average)

Clinical Signs

Hyperkalemic Periodic Paralysis is a genetically determined disorder which causes attacks of weakness and flaccid paralysis. Attacks last from 10 min to 1 hour, very rarely up to 1-2 days. Some patients experience only a few attacks over their lifetime, others have attacks every day. Diagnosis is suggested by attacks of weakness during which the patient's serum potassium is above 5.0 mmol/l or rises at least .5 of a mmol/l above their normal level when not in an attack.