Two patients presenting with lower extremity paralysis and abnormal electrocardiogram.
Acute bilateral lower extremity paralysis is a medical emergency frequently caused by spinal cord pathology. A few systemic diseases including metabolic and endocrine abnormalities, however, can also present with lower extremity paralysis. In such cases, an abnormal electrocardiogram can immediately point to a likely systemic etiology. In this report, we present 2 patients with a near carbon-copy presentation where previously healthy Hispanic men woke up in the morning not being able to get out of bed because of severe lower extremity weakness. In both cases, abnormal electrocardiograms on presentation pointed to the most likely diagnosis, which was quickly confirmed by simple laboratory testing. The appropriate evaluation and management of such patients are discussed.
Department of Internal Medicine, Carolinas Medical Center, Charlotte, NC 28232, USA.
Michael D
MD
Morgan
Adam
A
Ligler
Michael D
MD
Boswell
Laszlo
L
Littmann
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D013956:Antithyroid Agents / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D020514:Hypokalemic Periodic Paralysis / Q000175:diagnosis* / Q000188:drug therapy*; D035002:Lower Extremity; D008297:Male; D008713:Methimazole / Q000627:therapeutic use; D011188:Potassium / Q000627:therapeutic use; D011433:Propranolol / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D013956:Antithyroid Agents; D008713:Methimazole; D011433:Propranolol; D011188:Potassium