Thyrotoxic periodic paralysis

Thyrotoxic periodic paralysis (TPP) is a condition characterized by occasional episodes of muscle weakness and sometimes a lower than normal level of potassium in the blood. It is one of two types of periodic paralyses associated with thyrotoxicosis, the other being hypokalemic periodic paralysis.

Signs and symptoms

The primary symptom of thyrotoxic periodic paralysis is the occurrence of occasional episodes of muscle weakness, which may be mild and barely noticeable or may be severe enough to cause paralysis. These episodes often occur after physical activity or high-carbohydrate meals. Other symptoms may include muscle stiffness, cramping, and tenderness.

Causes

Thyrotoxic periodic paralysis is caused by an overactive thyroid gland (thyrotoxicosis), which can be triggered by various conditions such as Graves' disease, toxic multinodular goiter, and thyroiditis. The exact mechanism by which thyrotoxicosis leads to periodic paralysis is not fully understood, but it is believed to involve a defect in the ion channels of muscle cells.

Diagnosis

The diagnosis of thyrotoxic periodic paralysis is based on the patient's symptoms and medical history, as well as laboratory tests showing low levels of potassium during an attack and evidence of thyrotoxicosis. Other tests may include electromyography (EMG) and nerve conduction studies.

Treatment

The treatment of thyrotoxic periodic paralysis involves managing the underlying thyrotoxicosis, usually with medications such as beta blockers and antithyroid drugs. In severe cases, thyroidectomy (surgical removal of the thyroid gland) may be necessary. During an attack, treatment may involve intravenous administration of potassium.

See also

• Hypokalemic periodic paralysis
• Hyperkalemic periodic paralysis
• Andersen-Tawil syndrome

References

Thyrotoxic periodic paralysis Resources
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