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    Periodic Paralysis

    Periodic Paralysis is a topic covered in the 5-Minute Emergency Consult.

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    Basics

    Description

    • Periodic paralysis (PP): Disorder of muscle metabolism usually inherited that leads to flaccid extremity weakness. Exacerbated by hyperkalemia, hypokalemia, thyrotoxicosis
    • Primary: Familial AD mutation skeletal muscle calcium, sodium, or potassium channel
    • Secondary: Thyrotoxic, hypokalemia, hyperkalemia

    Epidemiology

    Incidence and Prevalence Estimates
    • Hypokalemic PP (HypoPP):
      • MC, 1:100,000 prevalence
      • 1/3 new AD mutations
    • Hyperkalemic PP (HyperPP):
      • 1:200,000 prevalence
      • 90% of people with mutation will have clinical symptoms
    • Thyrotoxic PP (ThyroPP):
      • Incidence 2% in patients with thyrotoxicosis
      • Higher in Asians
      • Subset of HypoPP, clinically identical
    • Andersen–Tawil:
      • Subset of HypoPP
      • Rare
      • Prevalence unknown

    Etiology

    • Mutation of skeletal muscle Na channel gene:
      • SCN4A
      • HypoPP, HyperPP:
        • AD inheritance
        • Spontaneous mutation
    • Mutation of skeletal muscle calcium channel gene CACN1AS:
      • HypoPP
    • Mutation of KCNJ2 gene:
      • Andersen–Tawil:
        • AD inheritance
        • 50% spontaneous
    • M>F
    • Age of onset:
      • HypoPP:
        • 1st or 2nd decade
      • HyperPP:
        • 1st decade
      • Andersen–Tawil:
        • 1st or 2nd decade
      • ThyroPP:
        • 2nd–5th decade

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    Citation

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    TY - ELEC T1 - Periodic Paralysis ID - 307662 ED - Barkin,Adam Z, ED - Barkin,Roger M, ED - Hayden,Stephen R, ED - Rosen,Peter, ED - Schaider,Jeffrey J, ED - Shayne,Philip, ED - Wolfe,Richard E, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307662/all/Periodic_Paralysis PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -