Hypokalemic sensory overstimulation.
This report describes 2 generations of a family with symptoms of sensory overstimulation that exhibit a potassium sensitivity similar to that seen in hypokalemic periodic paralysis. The sensory overstimulation is characterized by a subjective experience of sensory overload and a relative resistance to lidocaine local anesthesia. The sensory overload is treatable with oral potassium gluconate, with onset of the therapeutic effect in approximately 20 minutes. The effect of potassium is reminiscent of its effect in the channelopathies underlying hypokalemic periodic paralysis, and the resistance to lidocaine applied peripherally suggests a peripheral sensory localization to the abnormality. The phenotype overlaps with that of attention deficit disorder, raising the possibility of subtypes of attention deficit disorder that have a peripheral sensory cause and novel forms of therapy.
Segal
Michael M
MM
SimulConsult, Inc, Chestnut Hill, Massachusetts, USA. jcn@simulconsult.com
Rogers
Gary F
GF
Needleman
Howard L
HL
Chapman
Catherine A
CA
D000161:Acoustic Stimulation / Q000009:adverse effects; D000293:Adolescent; D000779:Anesthetics, Local / Q000494:pharmacology; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D003937:Diagnosis, Differential; D004351:Drug Resistance; D005260:Female; D005942:Gluconates / Q000008:administration & dosage; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007008:Hypokalemia / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008012:Lidocaine / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D010775:Photic Stimulation / Q000009:adverse effects; D017680:Potassium Compounds / Q000008:administration & dosage* / Q000097:blood; D012678:Sensation Disorders / Q000150:complications* / Q000188:drug therapy
D000779:Anesthetics, Local; D005942:Gluconates; D017680:Potassium Compounds; D008012:Lidocaine; C030691:gluconic acid