title: Paralysis that easily reverses: a case of thyrotoxic periodic paralysis.
abstract: Thyrotoxic periodic paralysis is a potentially life-threatening condition associated with recurrent episodes of muscle weakness and hypokalaemia due to hyperthyroidism. Diagnosis is often delayed or misdiagnosed due to its rarity in the western world and subtle features of hyperthyroidism on initial presentation. Here we present the case of a 25-year-old man who presented to the emergency department (ED) with sudden onset weakness of bilateral upper and lower extremities. His labs revealed hypokalaemia with elevated T4 and suppressed thyroid-stimulating hormone and he was diagnosed with thyrotoxic periodic paralysis. He was treated with potassium repletion, atenolol and methimazole with complete reversal of his paralysis within the next day. Unfortunately, he failed to keep the follow-up appointment after discharge, ran out of his methimazole and landed up in the ED again.
authors.affiliation: Department of Internal Medicine, Reading Health System, West Reading, Pennsylvania, USA.
authors.forename: Niranjan
authors.identifier: http://orcid.org/0000-0003-3340-6106
authors.initials: N
authors.lastname: Tachamo
authors.affiliation: Reading Hospital and Medical Center, Reading, Pennsylvania, USA.
authors.forename: Saroj
authors.initials: S
authors.lastname: Lohani
authors.affiliation: Reading Hospital and Medical Center, Reading, Pennsylvania, USA.
authors.forename: Salik
authors.initials: S
authors.lastname: Nazir
authors.affiliation: Department of Internal Medicine, Reading Health System, West Reading, Pennsylvania, USA.
authors.forename: Noelle
authors.initials: N
authors.lastname: Juliano
mesh_terms: D058671:Adrenergic beta-1 Receptor Antagonists / Q000627:therapeutic use; D000328:Adult; D013956:Antithyroid Agents / Q000627:therapeutic use; D001262:Atenolol / Q000627:therapeutic use; D006801:Humans; D007008:Hypokalemia / Q000188:drug therapy / Q000209:etiology; D020514:Hypokalemic Periodic Paralysis / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D008713:Methimazole / Q000627:therapeutic use; D011188:Potassium / Q000627:therapeutic use; D013971:Thyrotoxicosis / Q000097:blood / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood
chemical_list: D058671:Adrenergic beta-1 Receptor Antagonists; D013956:Antithyroid Agents; D001262:Atenolol; D008713:Methimazole; D013972:Thyrotropin; D013974:Thyroxine; D011188:Potassium