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The Importance to Physicians of Support Groups for Rare Conditions

Are Weakness and Fatigue Between Paralytic Attacks Symptoms of Periodic Paralysis?

Parents of some children with Periodic Paralysis will need to work with the school to achieve a plan which will allow their child to reach their full potential. The information in this article reflects the experiences of children in US schools. We hope it will be helpful to parents, school administrators, teachers, school nurses and physicians as they work together.

Life is a daily challenge for the child with periodic paralysis.

Periodic Paralysis poses unique problems for school-age youngsters. Because young PP patients usually look perfectly normal, and may even look extremely muscular and fit, it's hard for school staff to understand what a challenge daily life can be for them. But these children's strength may vary widely from day to day, even hour to hour, which is not just frustrating for teachers to cope with but extremely difficult for the child as well.

Acetazolamide (aka Diamox) is frequently prescribed as therapy for the periodic paralyses. While most patients take this drug without incident it can interact with other drugs. Physicians should be aware of potential problems which might arise.

Patients with Sodium channel HyperKPP and PMC mutations are at increased risk of Malignant Hyperthermia;

Periodic Paralysis Patients at Increased Risk of MH

Patients with Hyperkalemic periodic paralysis and Paramyotonia Congenita are at increased risk for Malignant Hyperthermia (MH) during surgery. 

Patients who take potassium chloride long-term, i.e., are at risk for developing vitamin B-12 deficiency. Potassium supplements such as K-Dur, Micro-K, Slow-K, K-Lyte, etc. interfere with the absorption of vitamin B-12 and can eventually lead to the depletion of body stores of this crucial vitamin. ^{1, 2, 3}

The regular colonoscopy prep can cause a hypokalemic episode in a patient with hypokalemic periodic paralysis. This colonoscopy prep, adapted to avoid hypokalemia, has been used by numerous patients with HypoKPP on the HKPP Listserv without provoking an episode afterwards. 

Colonoscopy Prep:

Day 1 Normal diet with an herbal tea laxative before bed.

Day 2 No solid foods, milk products or liquids with red or purple coloring; Suggested liquids are low sodium chicken stock, tea without milk, and water throughout the day.