Clinical and Metabolic Features of Thyrotoxic Periodic Paralysis in 24 Episodes

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Abstract
THYROTOXIC periodic paralysis (TPP) is an uncommon disorder characterized by simultaneous thyrotoxicosis, hypokalemia, and paralysis that occurs primarily in males of Asian descent, including patients of Japanese, Chinese, Vietnamese, Korean, Filipino, American Indian, and Hispanic ancestry.1-12 Although the association of thyrotoxicosis and periodic paralysis has been well known since 1931,13 TPP is often not recognized when first seen because of a lack of familiarity with the disorder in the United States, although the immigration of people from Asia and Latin America has increased. We retrospectively reviewed all case records of patients with TPP seen at Santa Clara Valley Medical Center, San Jose, Calif, during a 15-year period, and from these records we determined the prevalence of electrolyte abnormalities, including hypokalemia, rebound hyperkalemia, hypophosphatemia, and hypomagnesemia. We also examined diagnostic difficulties occurring, during which the patient is first seen, when TPP is often thought to be Guillain-Barré syndrome, spinal cord compression, familial periodic paralysis, or sporadic periodic paralysis.