Clinical Study of Thyrotoxic Periodic Paralysis in the Emergency Department

ABSTRACT

PURPOSE: Thyrotoxic periodic paralysis (TPP) is not an uncommon disorder in patient with acute muscle weakness in the emergency department. However, many patients with TPP are misdiagnosed, leading to improper treatment. So, we analyze the clinical characteristics of TPP to make diagnosis and treatment properly. METHODS: The medical records of the patients confirmed as TPP by using thyroid function test from January 1998 to December 2002 were reviewed retrospectively. RESULTS: TPP occurs predominantly in males, especially young males, during dawn or morning. It's predisposing factors were heavy meals, physical exertion and alcohol drinking. Most patients were hypokalemic and in a normal acid-base state. Systolic hypertension and tachycardia were common in TPP because of the hyperadrenergic state. When hyperthyroidism was conversed to normal thyroid state, paralysis did not occur. CONCLUSION: There were several clinical clues to the diagnosis of TPP. Rapid and accurate diagnosis of TPP is important, so emergency physicians must know its clinical characteristics.