Thyrotoxic Periodic Paralysis- A Clinical Review

Thyrotoxic periodic paralysis (TPP) is not a uncommon condition often seen in Asian males characterized by sudden onset hyperthyroidism-related hypokalemia and paralysis. Intracellular shift of potassium due to activation of thyroid hormone sensitive Na+/K+ ATPase is the possible pathological mechanism of hypokalemia, rather than depletion of potassium from the body, thus redistributive hypokalemia. Treatment involves correction of underlying hyperthyroidism, prevention of intracellular shift of potassium with non selective beta blockers and potassium replacement in emergency condition. Early identification of TPP is important for appropriate treatment and prevention of further episodes of hypokalemia or rebound hyperkalemia.