A Typical Presentation of Hypothyroidism: Recurrent Hypokalemic Paralysis

Recurrent hypokalemic paralysis as a presentation of hypothyroidism is rare in the literature. This transient and episodic neurological condition is commonly associated with thyrotoxicosis. We report a case of young male admitted with recurrent paralytic attacks since last 2 year. He had no symptom of hypothyroidism. He had weakness of all four limbs, delayed relaxation of ankle jerks, and normal higher mental function. There was no enlargement of thyroid. Serum potassium level ranged from 1.9 to 3.4 meq/L during attack with high serum creatine phosphokinase level. Electromyography was normal. Follow up shows satisfactory result with thyroxine replacement. It is an extremely rare and unusual presentation of hypothyroidism, and to our best knowledge, it is the seventh case report in the literature.