Abstract

Background: Thyrotoxic Periodic Paralysis (TPP) is a potentially lethal manifestation of hyperthyroidism, which is characterized by hypokalemia and muscular weakness due to intracellular shift of potassium. It is a rare complication of hyperthyroidism, which, in more than 90% of cases, is found in Asian populations with 10-24% prevalence in hyperthyroid patients. Although Graves' disease represents the most common cause, TPP can appear with hyperthyroidism of any origin. The combination of clinical features of hyperthyroidism with hypokalemia, hypophosphatemia, and normal arterial acid-base balance provides the best indication of TPP. The underlying hyperthyroidism may often be subtle, causing difficulty in early diagnosis. Case Report: We describe a 42-year old male with no co-morbidities, who presented to our hospital with complaints of recurrent episodes of paraparesis. Finally, the patient was diagnosed as a case of thyrotoxic periodic paralysis even though patient had no symptoms of thyrotoxicosis. The patient responded dramatically to the administration of potassium supplements, beta blockers and anti-thyroid drugs. Conclusion: All the patients with hypokalemic periodic paralysis should be investigated for thyrotoxicosis because management of thyrotoxicosis is essential to prevent further attacks of TPP. Absence of clinical features of thyrotoxicosis in TPP is common.

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