Periodic paralysis - hypokalemic
Muscle weakness that involves the breathing or swallowing muscles is an emergency situation. Dangerous heart arrhythmias may also occur during attacks.
The goals of treatment are relief of symptoms and prevention of further attacks.
Potassium that is given during an attack may stop the attack. It is preferred that potassium be given by mouth, but if weakness is severe, potassium may need to be given through a vein (IV). Note: Potassium, especially intravenous potassium, should be given with caution, especially in individuals with kidney disease.
Taking potassium supplements will not prevent attacks.
Avoiding alcohol and eating a low-carbohydrate diet may help.
A medicine called acetazolamide prevents attacks in many cases. If you take this medicine, your doctor may tell you to also take potassium supplements because acetazolamide may cause your body to lose potassium.
Triamterene or spironolactone may help to prevent attacks in people who do not respond to acetazolamide.
Hypokalemic periodic paralysis responds well to treatment. Treatment may prevent, and even reverse, progressive muscle weakness. Although muscle strength is initially normal between attacks, repeated attacks may eventually cause worsening and permanent muscle weakness between attacks.
Call your health care provider if you have intermittent muscle weakness, particularly if there is a family history of periodic paralysis.
Go to the emergency room or call the local emergency number (such as 911) if you faint or have difficulty breathing, speaking, or swallowing. These are emergency symptoms.
Barohn RJ. Muscle diseases. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 447.
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