In today’s AM report, Dr. Hanna presented a very interesting case of a patient with Thyrotoxic periodic paralysis.

Key learning points:

• The diagnosis of Thyrotoxic periodic paralysis (TPP) is made when a patient presents with infrequent paralytic attacks and is found to have hypokalemia and hyperthyroidism.
• Any cause of hyperthyroidism can be associated with thyrotoxic PP
• Precipitants for attacks include exercise, carbohydrate load and stress.
• Attacks of periodic paralysis will cease with return to euthyroid state. Use propranolol until euthyroidism is achieved.

High Yield: Although patients are found to be hypokalemic during the attack, this is due to intracellular K+ shifts, rather than true depletion of potassium. Therefore, you must replete the K+ carefully as patients are at risk for rebound hyperkalemia.