A Rare Case of Thyrotoxic Periodic Paralysis 17-Year-old-Boy with Graves' Disease

Thyrotoxic periodic paralysis is an uncommon hyperthyroidism?related condition characterized by sudden-onset, recurrent and reversible episodes of muscle weakness. We reported one patient male, 17-year-old with sudden onset tetraparesis, inability to urinate without breathing difficulty. History of palpitation and increase of apetite since one month prior to admission. He also complained weight loss for the last two months. Physical examination revealed soft diffuse symmetric mass on anterior part of neck, 4x5 cm in size, fine border, fixed, moved when swallowing, no pain on palpation. The motor grade was II on upper limbs and I on lower limbs. Laboratory examinations showed severe hypokalemia, low TSH, low FT3, high FT4, and high TRab. Electrocardiography results were sinus tachycardia, right bundle branch block and inferior ischemic. Thyroid ultrasonography revealed enlargement of right and left thyroid and isthmus with hypervascularity, according to the Graves? disease. After the management with antithyroid drug, beta-adrenergic blocker and potassium supplementation for TPP, he has remained euthyroid state and symptom free on the follow-up.