Acetazolamide-Induced Weakness in Paramyotonia Congenita

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Abstract
Acetazolamide is often an effective prophylaxis for hypokalemic and hyperkalemic periodic paralysis. A patient with paramyotonia congenita, a related disorder with myotonia and episodic weakness, was studied during treatment with acetazolamide. Although the patient''s myotonia was virtually abolished, severe quadriparesis was produced during each trial of acetazolamide. This response distinguished this patient''s condition from other forms of familial periodic paralysis and suggested that acetazolamide may be deleterious to some patients with periodic paralysis.