Thyrotoxic Periodic Paralysis

Abstract

Thyrotoxic hypokalemic paralysis is a rare complication of hyperthyroidism, characterized by acute episodes of muscle weakness associated with a decrease in serum potassium due to its translocation into cells. This process is explained by increased Na⁺/K⁺ ATPase activity in skeletal muscle, stimulated by thyroid hormones and β-adrenergic activation. We present the case of a patient who presented to the emergency department with acute, predominantly proximal muscle weakness, accompanied by severe hypokalemia. During clinical and laboratory evaluation, findings consistent with thyrotoxicosis were identified, confirming the diagnosis of hypokalemic paralysis secondary to hyperthyroidism. Treatment consisted of careful potassium replacement to correct the hypokalemia, the use of beta-blockers to control adrenergic symptoms, and management of the underlying hyperthyroidism. These interventions allowed for the progressive recovery of muscle strength and stabilization of the patient.