Table 3
| Question | If positive, suggests: |
| Family history | hyperPP, hypoPP, ATS, PMC, MC, PAM |
| Carbohydrates induce attacks | TPP, hypoPP, +/- PMC, ATS |
| Carbohydrates ameliorate attacks | hyperPP, ATS, PMC, PAM |
| Stiffness after exercise | PMC, MC |
Which medications are used in the treatment of hypokalemic periodic paralysis?
Acetazolamide prophylaxis in hypokalemic periodic paralysis. N Engl J Med 1968; 278:582. Links TP, Arnoldus EP, Wintzen AR, et al. The calcium channel blocker verapamil in hypokalemic periodic paralysis. Muscle Nerve 1998; 21:1564.
What is hypokalemic periodic paralysis?
Hypokalemic periodic paralysis (hypoPP or hypoKPP) is a rare disorder in which a person experiences episodes of painless muscle weakness and often paralysis. It’s the most common of several genetic disorders that cause periodic paralysis.
What are the different types of periodic paralysis?
The different types of periodic paralyses are distinguished by what happens to potassium levels in the blood (specifically the serum, or fluid, portion of the blood). In the hyperkalemic type (hyperKPP), high serum potassium levels cause attacks of temporary muscle weakness that can result in paralysis when severe.
What is a hypokalemic attack (hypoKPP)?
In the hypokalemic type (hypoKPP), low serum potassium levels can trigger attacks. ( Kalemic refers to potassium; hyper means too much and hypo too little.)
Can hypokalemic periodic paralysis be treated?
Hypokalemic periodic paralysis treatment Treatment consists of diet changes and avoiding things that trigger your attacks. Your doctor may also want to treat you with medications. Treatment involves avoiding your known triggers.
What triggers hypokalemic periodic paralysis?
Hypokalemic PP (hypo refers to low potassium). Attacks may result from low blood levels of potassium. Other triggers may include strenuous exercise, foods with a lot of sugars and starches (carbohydrates), licorice, stress, cold temperatures, and certain medicines. This is the most common form of PP.
What are possible treatments or cures for periodic paralysis?
Your doctor may also try dichlorphenamide or diuretics such as acetazolamide. For ATS, potassium supplements can prevent attacks of paralysis. You may need to take heart medicines such as beta-blockers to control an abnormal heart rhythm.
How do you treat hyperkalemic periodic paralysis?
Hyperkalemic periodic paralyses Fortunately, attacks are usually mild and rarely require treatment. Weakness promptly responds to high-carbohydrate foods. Beta-adrenergic stimulants, such as inhaled salbutamol, also improve the weakness (but are contraindicated in patients with cardiac arrhythmias).
How long does it take to recover from low potassium?
Periodic paralysis may be hereditary (genetic) and may be precipitated by excessive exercise, high carbohydrate or high salt meal, or may occur without apparent cause. Treatment by potassium replacement intravenously is effective, and recovery occurs within 24 hours.
How long does hypokalemic periodic paralysis last?
Some patients might get attack only once in a lifetime, while others may get it several times a week. [2][14] Women tend to have fewer attacks than men. And the duration of each attack also varies, ranging from minutes to days and can last up to several hours before they resolve spontaneously.
What is the best medicine for paralysis?
Aconite napellus is considered as the sovereign remedy for almost every species of paralysis in homoepathy. Gelsemium sempervirens (Gels.) is another plant used in homeopathic for treatment of paralysis.
What is the injection for paralysis?
Botox® is one of the most widely known brands of botulinum toxin injections. Botulinum toxins are neurotoxins that affect nerves and cause muscle weakening. You might get a botulinum toxin injection for cosmetic or medical reasons.
How long does it take to heal from paralysis?
The severity of symptoms can range from mild weakness to complete paralysis. Research shows that symptoms tend to appear and progress over 72 hours or so, after which they stabilize. In most cases, symptoms will resolve without treatment over time, but they can take months or years to disappear completely.
Why acetazolamide is used in hypokalemic periodic paralysis?
A shift of extracellular to intracellular potassium has been suggested as a cause or concomitant of attacks in hypokalemic periodic paralysis. Since metabolic acidosis can diminish intracellular potassium,15 acetazolamide might reverse a tendency to an intracellular shift of potassium through production of acidosis.
What is the prognosis for patients diagnosed with periodic paralysis?
The prognosis for the familial periodic paralyses varies. Chronic attacks may result in progressive weakness that persists between attacks. Some cases respond well to treatment, which can prevent or reverse progressive muscle weakness.
Can too much potassium cause paralysis?
In the hyperkalemic type (hyperKPP), high serum potassium levels cause attacks of temporary muscle weakness that can result in paralysis when severe.
What is Hypokalemic Periodic Paralysis ?
It is uncommon diesease marked by paralysis or muscle weakness. Hypokalemic Periodic Paralysis comes in the people in the form of sudden Paralysis attacks. These attacks are very harmful to the body of a person.
How is the treatment done?
The hypokalemic periodic paralysis doesn’t really have a proper treatment process but when the paralysis attack occurs the person needs to be taken to emergency. The emergency treatment’s first actions will be:
Who is eligible for the treatment? (When is the treatment done ?)
The patient will show certain symbols and sings, others around need to notice and report the patient’s health status to the doctors if the patient is showing signs that include.
Who is not eligible for the treatment?
The patient will not be treated for the hypokalemic periodic paralysis when these things occur:
Are there any Side Effects?
The medications are having their own different side effects some of them include but the attacks too damage the body as the side effect:
What are the post-treatment guidelines?
The treatment doesn’t really end because there is no treatment for curing it completely as the medication dichlorphenamide (Keveyis) and acetazolamide (Diamox) will help reducing the attacks and some people will be cured due to the constant treatment however there are many cases where the treatment continued for longer time and sometimes lifetime.
How long does it take to recover?
The person starts recovering between the attacks but after every period of attacks the damage is done to the body and will need to recover again after the attack.
What is hypokalemic periodic paralysis?
Hypokalemic periodic paralysis (HOKPP) is characterized by episodes of muscle paralysis associated with a fall in blood potassium levels ( hypokalemia ). [1] Episodes typically involve a temporary inability to move muscles in the arms and legs. [2] The first attack usually occurs in childhood or adolescence. Attacks can last for hours or days, and the frequency of attacks varies among people with HOKPP. The frequency is usually highest between the ages of 15 and 35, and then decreases with age. Some people with HOKPP also develop late-onset proximal myopathy. [3]
Is hypokalemic paralysis inherited?
Hypokalemic periodic paralysis (HOKPP) is inherited in an autosomal dominant manner. [3] . This means that having a change ( mutation) in only one copy of one of the responsible genes in each cell is enough to cause symptoms of the condition.
Genetics
Mutations in the following genes can cause hypokalemic periodic paralysis:
Signs and symptoms
Hypokalemic periodic paralysis is a condition that causes episodes of extreme muscle weakness typically beginning in childhood or adolescence. Most often, these episodes involve a temporary inability to move muscles in the arms and legs. Attacks cause severe weakness or paralysis that usually lasts from hours to days.
Diagnosis
Diagnosis can be achieved through a specialized form of electromyographic (EMG) testing called the long exercise test. This test measures the amplitude of a nerve response (called the Compound Muscle Action Potential or CMAP) for 40 to 50 minutes following a few minutes of exercise.
Treatment
Treatment of Hypokalemic periodic paralysis focuses on preventing further attacks and relieving acute symptoms. Avoiding carbohydrate-rich meals, strenuous exercise and other identified triggers, and taking acetazolamide or another carbonic anhydrase inhibitor, may help prevent attacks of weakness.
Prognosis
The prognosis for periodic paralysis varies. Overactivity, a diet that is not low in sodium and carbohydrates, or simply an unfortunate gene mutation can lead to a type of chronic, low level weakness called an “abortive attack,” or to permanent muscle damage.
Is hypokalemic PP a familial disease?
EPIDEMIOLOGY. Hypokalemic PP is the most common of the periodic paralyses, but is still quite rare, with an estimated prevalence of 1 in 100,000 [ 1 ]. Hypokalemic PP may be familial with autosomal dominant inheritance or may be acquired in patients with thyrotoxicosis [ 2-7 ]. (See "Thyrotoxic periodic paralysis" .)
Is PP hypokalemic or hyperkalemic?
PP is classified as hypokalemic when episodes occur in association with low potassium blood levels or as hyperkalemic when episodes can be induced by elevated potassium. Most cases of PP are hereditary, usually with an autosomal dominant inheritance pattern.
What is HKPP in medical terms?
Hypokalemic periodic paralysis (HKPP) is a rare genetic disorder with autosomal dominant inheritance and characterized by recurrent attacks of skeletal muscle weakness with associated hypokalemia which is precipitated by stress, cold, carbohydrate load, infection, glucose infusion, hypothermia, metabolic alkalosis, anesthesia, and steroids.
Is simple exercise good for potassium?
Simple exercise challenge, which is relatively safe, is partly helpful when the serum potassium is high or low. Specifically, ECG, TSH, free T3 and free T4 are the minimum indicated laboratory investigations, with renal and adrenal function also recommended.
Can hypokalemia cause paralysis?
Fluctuations in electrolytes, infection, and pain can lead to paralysis in the post-operative period. Hypokalemia manifests earlier than paralysis and so its correction can prevent paralysis.[9] . Dextrose containing solutions administered during surgery should be avoided and normal saline (0.9%) should be preferred.
What happens when you have hypokalemic paralysis?
People who have hypokalemic periodic paralysis experience episodes of extreme muscle weakness that can last for hours. Arms and legs are often affected, but sometimes, eye muscles and muscles involved in breathing and swallowing are affected. During these episodes, the patient’s blood potassium levels are unusually low. Some things that cause these episodes to happen are resting, eating a high-carb meal, and stress.
How long does hyperkalemic paralysis last?
The main symptom of hyperkalemic periodic paralysis is episodes of extreme muscle weakness. These episodes usually last 15 minutes to an hour, but can sometimes last much longer. It’s also possible to have a stiff feeling in your muscles even between full-blown episodes. Muscles all over the body can be affected by this disorder, but most often, it occurs in the arms, legs, and back. Hyperkalemic periodic paralysis sufferers have an increased level of potassium in their blood when these episodes happen, and eating potassium-rich foods is one trigger for these episodes. However, the episodes can also be caused by resting after exercise, stress, and cold.
Do you feel like you have periodic paralysis?
Do you, or someone you love, suffer from Periodic Paralysis? If you have Periodic Paralysis, you may sometimes feel like there isn’t much hope for your health to get better. You’re probably used to feeling confused and worried because you may not fully understand what’s going on with your body. Other people don’t always understand what is happening to you, either. It can be easy to feel pessimistic.
What causes hyperkalemic paralysis?
In hyperkalemic periodic paralysis, high levels of potassium in the blood interact with genetically caused abnormalities in sodium channels (pores that allow the passage of sodium molecules) in muscle cells, result ing in temporary muscle weakness and, when severe, in temporary paralysis. The disease is inherited in an autosomal dominant pattern, ...
What causes a paralysis in the heart?
This disease is caused by defects in a potassium channel normally present in skeletal and cardiac muscles. Mutations in this potassium channel gene interfere with the ability of a muscle to stay poised and ready to contract. As a result, periodic episodes of paralysis may occur, and the heartbeat can become irregular.
What is hyperkalemic potassium?
In the hyperkalemic type (hyperKPP), high serum potassium levels cause attacks of temporary muscle weakness that can result in paralysis when severe. In the hypokalemic type (hypoKPP), low serum potassium levels can trigger attacks. ( Kalemic refers to potassium; hyper means too much and hypo too little.)
What is hyperkpp in skeletal muscle?
HyperKPP is one of a group of diseases, called inherited myopathies, that causes problems with the tone and contraction of skeletal muscles. As in all forms of periodic paralysis, episodes of weakness in hyperKPP are caused by a temporary loss of muscle excitability.
When does hyperkpp onset?
HyperKPP has its onset in childhood. Unlike the case for most myopathies, some people with hyperKPP experience progressive, permanent muscle damage that occurs independently of the attacks. The frequency of attacks declines after middle age. Men and women are affected equally.
