Treatment:

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 acute 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, intravenous potassium may be necessary. Note: intravenous potassium should be given with caution, especially in individuals with kidney disease. Taking potassium will not prevent attacks.

A low-carbohydrate diet and avoidance of alcohol may be recommended.

Acetazolamide prevents attacks in many cases, possibly by reducing the flow of potassium from the bloodstream into the cells of the body. Potassium supplements may be necessary because acetazolamide may cause the body to lose potassium.

Triamterene or spironolactone may help to prevent attacks in people who do not respond to acetazolamide.

Expectations (prognosis):

Chronic attacks may eventually result in progressive muscle weakness that is present even between attacks. Hypokalemic periodic paralysis responds well to treatment. Treatment may prevent, and even reverse, progressive muscle weakness.

Complications:

• Kidney stones (a side effect of acetazolamide)
• Heart arrhythmias during attacks
• Difficulty breathing, speaking, or swallowing during attacks (rare)
• Progressive muscle weakness

Calling your health care provider:

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.