title: Acute quadriplegia from hyperkalemia: a case report and literature review.
abstract: BACKGROUND
  Hyperkalemia has been described as a rare and under recognized cause of acute quadriplegia.
  
  
  METHODS
  A 52-year-old man with end-stage renal disease presented with ascending quadriplegia and dyspnea for 2 days. He had life-threatening hyperkalemia (9.0 mEq/L). His electrocardiogram showed typical features of hyperkalemia. His symptoms improved in 30 minutes and completely resolved in 5 hours after emergent treatment of hyperkalemia. He admitted eating large amounts of high potassium foods and taking ibuprofen in uncertain quantities. We reviewed 62 articles and identified 73 patients with secondary hyperkalemic paralysis. Common presentations were diminished reflexes, quadriparesis/paralysis, respiratory involvement, and sensory loss. Almost half of all patients had potassium levels higher than 9 mEq/L. Complete recovery, achieved in 89% of patients, did not correlate either with the absolute potassium level or the degree to which it was corrected.
  
  
  CONCLUSIONS
  Hyperkalemia is a rare but treatable cause of acute flaccid paralysis that requires immediate treatment. Late diagnosis can delay appropriate treatment leading to cardiac arrhythmias and arrest.
authors.affiliation: Department of Neurology, Downstate Medical Center, State University of New York, New York, NY, USA.
authors.forename: Kessarin
authors.initials: K
authors.lastname: Panichpisal
authors.forename: Shefali
authors.initials: S
authors.lastname: Gandhi
authors.forename: Kenneth
authors.initials: K
authors.lastname: Nugent
authors.forename: Yaacov
authors.initials: Y
authors.lastname: Anziska
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000150:complications*; D016239:MEDLINE; D008297:Male; D008875:Middle Aged; D011188:Potassium / Q000097:blood; D011782:Quadriplegia / Q000209:etiology*; D055815:Young Adult
chemical_list: D011188:Potassium