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Hyperkalemic periodic paralysis - Treatment

Alternative Names

Paramyotonia congenita; Periodic paralysis - hyperkalemic

Treatment:

The goal of treatment is to relieve symptoms and prevent further attacks.

Attacks are seldom severe enough to require emergency treatment. However, weakness can become worse with repeated attacks, so treatment to prevent the attacks should occur as soon as possible.

Glucose or other carbohydrates (sugars) given during an attack may reduce the severity of the symptoms. Calcium or diuretics such as furosemide may need to be given through a vein to stop sudden attacks. Glucose and insulin may also need to be given through a vein (IV) to help reduce weakness without reducing potassium levels.

A medicine called acetazolamide prevents attacks in many cases. Thiazide diuretics such as chlorothiazide are also effective and have fewer side effects than acetazolamide.

Expectations (prognosis):

Sometimes attacks disappear later in life on their own. However, chronic attacks generally result in progressive muscle weakness that is present even between attacks.

Hyperkalemic periodic paralysis responds well to treatment. Treatment may prevent, and may even reverse, progressive muscle weakness.

Complications:

  • Kidney stones (a side effect of acetazolamide)
  • Heart arrhythmias during attacks (rare, not fatal)
  • 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.

  • Reviewed last on: 7/11/2008
  • Parul Patel, MD, Private Practice specializing in Nephrology and Kidney and Pancreas Transplantation, Affiliated with California Pacific Medical Center, Department of Transplantation, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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