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Hyperkalemic periodic paralysis

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Paramyotonia congenita; Periodic paralysis - hyperkalemic

Treatment:

The goals of treatment are relief of acute symptoms and prevention of 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. Intravenous calcium or diuretics such as furosemide may be needed to stop sudden attacks. Intravenous glucose and insulin cause potassium to move into the cell and may reduce weakness without a loss of total body potassium.

A high-carbohydrate diet may be recommended.

Acetazolamide, a medication that prevents attacks of familial periodic paralysis, is also effective in preventing attacks of hyperkalemic periodic paralysis. 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 intermittent muscle weakness occurs, 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 fainting , difficulty breathing , difficulty speaking or difficulty swallowing occur. These emergency symptoms are rare.

• Review Date: 7/25/2006
• Reviewed By: David M. Charytan, M.D., M.Sc., Department of Medicine, Division of Nephrology, Brigham and Women's Hospital, Boston, MA. Review provided by VeriMed Healthcare Network.

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