hypokalemic periodic paralysis

Summary

Summary: An autosomal dominant familial disorder characterized by recurrent episodes of skeletal muscle weakness associated with falls in serum potassium levels. The condition usually presents in the first or second decade of life with attacks of trunk and leg paresis during sleep or shortly after awakening. Symptoms may persist for hours to days and generally are precipitated by exercise or a meal high in carbohydrates. (Adams et al., Principles of Neurology, 6th ed, p1483)

Top Publications

  1. Kung A. Clinical review: Thyrotoxic periodic paralysis: a diagnostic challenge. J Clin Endocrinol Metab. 2006;91:2490-5 pubmed
    ..The aim of this article was to review the clinical presentation, pathogenesis, and management of thyrotoxic periodic paralysis (TPP)...
  2. Kim J, Kim M, Lee S, Kim D, Lee B. The genotype and clinical phenotype of Korean patients with familial hypokalemic periodic paralysis. J Korean Med Sci. 2007;22:946-51 pubmed
    Familial hypokalemic periodic paralysis (HOPP) is a rare autosomal-dominant disease characterized by reversible attacks of muscle weakness occurring with episodic hypokalemia...
  3. Ryan D, Da Silva M, Soong T, Fontaine B, Donaldson M, Kung A, et al. Mutations in potassium channel Kir2.6 cause susceptibility to thyrotoxic hypokalemic periodic paralysis. Cell. 2010;140:88-98 pubmed publisher
    Thyrotoxic hypokalemic periodic paralysis (TPP) is characterized by acute attacks of weakness, hypokalemia, and thyrotoxicosis of various etiologies...
  4. Li F, Li Q, Tan Z, Zhang S, Liu J, Zhao E, et al. A novel mutation in CACNA1S gene associated with hypokalemic periodic paralysis which has a gender difference in the penetrance. J Mol Neurosci. 2012;46:378-83 pubmed publisher
    b>Hypokalemic periodic paralysis (HypoPP) is an autosomal dominant disorder characterized by periodic attacks of muscle weakness associated with a decrease in the serum potassium level...
  5. Sung C, Cheng C, Lo Y, Lin M, Yang S, Hsu Y, et al. Genotype and phenotype analysis of patients with sporadic periodic paralysis. Am J Med Sci. 2012;343:281-5 pubmed publisher
    Sporadic periodic paralysis (SPP), the second leading cause of hypokalemic periodic paralysis (HPP) in Asia, has a presentation similar to that of familial periodic paralysis (FPP) and is caused by gene mutations in the calcium (Ca(2+)) (..
  6. Struyk A, Cannon S. A Na+ channel mutation linked to hypokalemic periodic paralysis exposes a proton-selective gating pore. J Gen Physiol. 2007;130:11-20 pubmed
    The heritable muscle disorder hypokalemic periodic paralysis (HypoPP) is characterized by attacks of flaccid weakness, brought on by sustained sarcolemmal depolarization...
  7. Carle T, Lhuillier L, Luce S, Sternberg D, Devuyst O, Fontaine B, et al. Gating defects of a novel Na+ channel mutant causing hypokalemic periodic paralysis. Biochem Biophys Res Commun. 2006;348:653-61 pubmed
    b>Hypokalemic periodic paralysis type 2 (hypoPP2) is an inherited skeletal muscle disorder caused by missense mutations in the SCN4A gene encoding the alpha subunit of the skeletal muscle Na+ channel (Nav1.4)...
  8. Miller T, Dias da Silva M, Miller H, Kwiecinski H, Mendell J, Tawil R, et al. Correlating phenotype and genotype in the periodic paralyses. Neurology. 2004;63:1647-55 pubmed
    ..Periodic paralyses and paramyotonia congenita are rare disorders causing disabling weakness and myotonia. Mutations in sodium, calcium, and potassium channels have been recognized as causing disease...
  9. Sternberg D, Maisonobe T, Jurkat Rott K, Nicole S, Launay E, Chauveau D, et al. Hypokalaemic periodic paralysis type 2 caused by mutations at codon 672 in the muscle sodium channel gene SCN4A. Brain. 2001;124:1091-9 pubmed
    ..They also provide new clues for understanding the mechanisms behind functional and structural alterations of the skeletal muscle in hypoPP. ..

More Information

Publications69

  1. Wu F, Mi W, Burns D, Fu Y, Gray H, Struyk A, et al. A sodium channel knockin mutant (NaV1.4-R669H) mouse model of hypokalemic periodic paralysis. J Clin Invest. 2011;121:4082-94 pubmed publisher
    b>Hypokalemic periodic paralysis (HypoPP) is an ion channelopathy of skeletal muscle characterized by attacks of muscle weakness associated with low serum K+. HypoPP results from a transient failure of muscle fiber excitability...
  2. Sokolov S, Scheuer T, Catterall W. Ion permeation and block of the gating pore in the voltage sensor of NaV1.4 channels with hypokalemic periodic paralysis mutations. J Gen Physiol. 2010;136:225-36 pubmed publisher
    b>Hypokalemic periodic paralysis and normokalemic periodic paralysis are caused by mutations of the gating charge-carrying arginine residues in skeletal muscle Na(V)1...
  3. Hannon M, Behan L, Agha A. Thyrotoxic periodic paralysis due to excessive L-thyroxine replacement in a Caucasian man. Ann Clin Biochem. 2009;46:423-5 pubmed publisher
    ..This disorder has been described in Asian subjects but, to our knowledge, thyrotoxic periodic paralysis secondary to excessive L-thyroxine replacement has never been described in Caucasians...
  4. Vicart S, Sternberg D, Fournier E, Ochsner F, Laforet P, Kuntzer T, et al. New mutations of SCN4A cause a potassium-sensitive normokalemic periodic paralysis. Neurology. 2004;63:2120-7 pubmed
    ..Periodic paralysis is classified into hypokalemic (hypoPP) and hyperkalemic (hyperPP) periodic paralysis according to variations of blood potassium levels during attacks...
  5. Jurkat Rott K, Weber M, Fauler M, Guo X, Holzherr B, Paczulla A, et al. K+-dependent paradoxical membrane depolarization and Na+ overload, major and reversible contributors to weakness by ion channel leaks. Proc Natl Acad Sci U S A. 2009;106:4036-41 pubmed publisher
    ..Acetazolamide normalized this increased frequency of P2 fibers. The findings mimic hypokalemic periodic paralysis (HypoPP), a channelopathy characterized by hypokalemia-induced weakness...
  6. Struyk A, Markin V, Francis D, Cannon S. Gating pore currents in DIIS4 mutations of NaV1.4 associated with periodic paralysis: saturation of ion flux and implications for disease pathogenesis. J Gen Physiol. 2008;132:447-64 pubmed publisher
    S4 voltage-sensor mutations in CaV1.1 and NaV1.4 channels cause the human muscle disorder hypokalemic periodic paralysis (HypoPP)...
  7. Kim J, Lee K, Hur J. A Korean family of hypokalemic periodic paralysis with mutation in a voltage-gated calcium channel (R1239G). J Korean Med Sci. 2005;20:162-5 pubmed
    b>Hypokalemic periodic paralysis (HOPP) is a rare disease characterized by reversible attacks of muscle weakness accompanied by episodic hypokalemia...
  8. Fraer M. A mask and many faces: hypokalemic periodic paralysis. South Med J. 2008;101:887 pubmed publisher
  9. Jurkat Rott K, Mitrovic N, Hang C, Kouzmekine A, Iaizzo P, Herzog J, et al. Voltage-sensor sodium channel mutations cause hypokalemic periodic paralysis type 2 by enhanced inactivation and reduced current. Proc Natl Acad Sci U S A. 2000;97:9549-54 pubmed
    The pathomechanism of familial hypokalemic periodic paralysis (HypoPP) is a mystery, despite knowledge of the underlying dominant point mutations in the dihydropyridine receptor (DHPR) voltage sensor...
  10. Yu T, Tseng C, Chuang Y, Yeung L, Lu K. Potassium chloride supplementation alone may not improve hypokalemia in thyrotoxic hypokalemic periodic paralysis. J Emerg Med. 2007;32:263-5 pubmed
    ..Muscle power recovered completely after i.v. drip of KCl, 20 mEq. Laboratory data revealed an underlying primary hyperthyroidism for which he was given anti-thyroid agents and beta-blockers...
  11. Fontaine B, Fournier E, Sternberg D, Vicart S, Tabti N. Hypokalemic periodic paralysis: a model for a clinical and research approach to a rare disorder. Neurotherapeutics. 2007;4:225-32 pubmed
    ..In this review, we plan to demonstrate how research has improved our knowledge of hypokalemic periodic paralysis and the way we evaluate, advise, and treat patients...
  12. Pappa T, Papanastasiou L, Markou A, Androulakis I, Kontogeorgos G, Seretis A, et al. Thyrotoxic periodic paralysis as the first manifestation of a thyrotropin-secreting pituitary adenoma. Hormones (Athens). 2010;9:82-6 pubmed
    ..Despite its rarity, TSH-secreting pituitary adenoma should be included in the differential diagnosis of TPP...
  13. Abbasi B, Sharif Z, Sprabery L. Hypokalemic thyrotoxic periodic paralysis with thyrotoxic psychosis and hypercapnic respiratory failure. Am J Med Sci. 2010;340:147-53 pubmed publisher
  14. Dias da Silva M, Cerutti J, Arnaldi L, Maciel R. A mutation in the KCNE3 potassium channel gene is associated with susceptibility to thyrotoxic hypokalemic periodic paralysis. J Clin Endocrinol Metab. 2002;87:4881-4 pubmed
    ..The most common causes are Familial Hypokalemic Periodic Paralysis (FHypoKPP), an autosomal dominant disease, and Thyrotoxic Hypokalemic Periodic Paralysis (THypoKPP), ..
  15. Hsu F, Tsai W, Chau T, Chen H, Chen Y, Lin S. Thyrotropin-secreting pituitary adenoma presenting as hypokalemic periodic paralysis. Am J Med Sci. 2003;325:48-50 pubmed
    Thyrotropin (TSH)-secreting pituitary adenoma presenting with hypokalemic periodic paralysis is extraordinarily rare and may be misdiagnosed...
  16. Tagami T, Usui T, Shimatsu A, Naruse M. Toxic thyroid adenoma presenting as hypokalemic periodic paralysis. Endocr J. 2007;54:797-803 pubmed
    Toxic thyroid adenoma presenting as hypokalemic periodic paralysis is extraordinarily rare. We describe a 26-year-old Japanese man who suffered from acute and painful muscle weakness of extremity in the morning...
  17. El Hennawy A, Nesa M, Mahmood A. Thyrotoxic hypokalemic periodic paralysis triggered by high carbohydrate diet. Am J Ther. 2007;14:499-501 pubmed
    Thyrotoxic hypokalemic periodic paralysis is an uncommon disorder characterized by elevated thyroid hormone, muscle weakness or paralysis, and intracellular shifts of potassium leading to hypokalemia...
  18. Kuzmenkin A, Muncan V, Jurkat Rott K, Hang C, Lerche H, Lehmann Horn F, et al. Enhanced inactivation and pH sensitivity of Na(+) channel mutations causing hypokalaemic periodic paralysis type II. Brain. 2002;125:835-43 pubmed
    ..This may explain a delay or prevention of paralytic attacks in patients by slight physical activity. Moreover, the histidine residues may be the target for a potential therapeutic action by acetazolamide...
  19. Wang W, Jiang L, Ye L, Zhu N, Su T, Guan L, et al. Mutation screening in Chinese hypokalemic periodic paralysis patients. Mol Genet Metab. 2006;87:359-63 pubmed
    ..familial periodic paralysis (FPP), and sporadic periodic paralysis (SPP) are the most common causes of hypokalemic periodic paralysis (hypoKPP)...
  20. Kim S, Lee Y, Kim J. Reduced expression and abnormal localization of the K(ATP) channel subunit SUR2A in patients with familial hypokalemic periodic paralysis. Biochem Biophys Res Commun. 2010;391:974-8 pubmed publisher
    Familial hypokalemic periodic paralysis is an autosomal-dominant channelopathy that features episodic attacks of flaccid paralysis with concomitant hypokalemia...
  21. Wang Q, Liu M, Xu C, Tang Z, Liao Y, Du R, et al. Novel CACNA1S mutation causes autosomal dominant hypokalemic periodic paralysis in a Chinese family. J Mol Med (Berl). 2005;83:203-8 pubmed
    b>Hypokalemic periodic paralysis (HypoPP) is an autosomal dominant disorder which is characterized by periodic attacks of muscle weakness associated with a decrease in the serum potassium level...
  22. Caciotti A, Morrone A, Domenici R, Donati M, Zammarchi E. Severe prognosis in a large family with hypokalemic periodic paralysis. Muscle Nerve. 2003;27:165-9 pubmed
    b>Hypokalemic periodic paralysis (HypoPP) is a channel disorder caused primarily by mutations in the human skeletal muscle alpha1 subunit (CACNA1S) of the dihydropyridine-sensitive calcium channel...
  23. Tran H, Kay S, Kende M, Doery J, Colman P, Read A. Thyrotoxic, hypokalaemic periodic paralysis in Australasian men. Intern Med J. 2003;33:91-4 pubmed
    ..The diagnosis should be considered in any Asian-Australian male presenting with sudden onset paralysis...
  24. Silva M, Chiamolera M, Kasamatsu T, Cerutti J, Maciel R. [Thyrotoxic hypokalemic periodic paralysis, an endocrine emergency: clinical and genetic features in 25 patients]. Arq Bras Endocrinol Metabol. 2004;48:196-215 pubmed
    Thyrotoxic hypokalemic periodic paralysis (THPP) is a medical emergency characterized by acute attacks of weakness, hypokalemia, and thyrotoxicosis that resolve with the treatment of hyperthyroidism...
  25. Jovanovic S, Du Q, Mukhopadhyay S, Swingler R, Buckley R, McEachen J, et al. A patient suffering from hypokalemic periodic paralysis is deficient in skeletal muscle ATP-sensitive K channels. Clin Transl Sci. 2008;1:71-4 pubmed publisher
    b>Hypokalemic periodic paralysis (HOPP) is a rare disease associated with attacks of muscle weakness and hypokalemia...
  26. Cesur M, Bayram F, Temel M, Ozkaya M, Kocer A, Ertorer M, et al. Thyrotoxic hypokalaemic periodic paralysis in a Turkish population: three new case reports and analysis of the case series. Clin Endocrinol (Oxf). 2008;68:143-52 pubmed
    ..This study aimed to conduct an analysis of THPP in a Turkish population, and is to our knowledge the first analysis of a homogeneous Caucasian group...
  27. Cheng C, Lin S, Lo Y, Yang S, Hsu Y, Cannon S, et al. Identification and functional characterization of Kir2.6 mutations associated with non-familial hypokalemic periodic paralysis. J Biol Chem. 2011;286:27425-35 pubmed publisher
    b>Hypokalemic periodic paralysis (hypoKPP) is characterized by episodic flaccid paralysis of muscle and acute hypokalemia during attacks...
  28. Bulman D, Scoggan K, van Oene M, Nicolle M, Hahn A, Tollar L, et al. A novel sodium channel mutation in a family with hypokalemic periodic paralysis. Neurology. 1999;53:1932-6 pubmed
    To identify the cause of hypokalemic periodic paralysis (HOKPP) in a family whose disease is not caused by a mutation in the dihydropyridine-sensitive (DHP) receptor alpha1-subunit gene (CACNA1S).
  29. Wu F, Mi W, Hernández Ochoa E, Burns D, Fu Y, Gray H, et al. A calcium channel mutant mouse model of hypokalemic periodic paralysis. J Clin Invest. 2012;122:4580-91 pubmed publisher
    b>Hypokalemic periodic paralysis (HypoPP) is a familial skeletal muscle disorder that presents with recurrent episodes of severe weakness lasting hours to days associated with reduced serum potassium (K+)...
  30. Jurkat Rott K, Lehmann Horn F. Do hyperpolarization-induced proton currents contribute to the pathogenesis of hypokalemic periodic paralysis, a voltage sensor channelopathy?. J Gen Physiol. 2007;130:1-5 pubmed
  31. Sokolov S, Scheuer T, Catterall W. Gating pore current in an inherited ion channelopathy. Nature. 2007;446:76-8 pubmed
    ..A survey of other ion channelopathies reveals numerous examples of mutations that would be expected to cause gating pore current, raising the possibility of a broader impact of gating pore current in ion channelopathies...
  32. Paul B, Hirudayaraj P, Baig M. Thyrotoxic periodic paralysis: an unusual presentation of weakness. Emerg Med J. 2003;20:E7 pubmed
    ..It is important to consider the diagnosis of thyrotoxic periodic paralysis in patients presenting with acute onset of weakness. The report discusses the epidemiology, presentation, treatment, and complications of this condition...
  33. Kim S, Kim U, Chae J, Kim D, Oh H, Kim B, et al. Identification of mutations including de novo mutations in Korean patients with hypokalaemic periodic paralysis. Nephrol Dial Transplant. 2001;16:939-44 pubmed
    ..However, there are few reports about the mutations of CACNA1S gene in other races...
  34. Schalin Jantti C, Laine T, Valli Jaakola K, Lonnqvist T, Kontula K, Valimaki M. Manifestation, management and molecular analysis of candidate genes in two rare cases of thyrotoxic hypokalemic periodic paralysis. Horm Res. 2005;63:139-44 pubmed
    b>Hypokalemic periodic paralysis as a complication of thyrotoxicosis (THypoKPP) is common in Asians but not well recognized in Western countries or pediatric patients, where most cases are due to the familial variant (FHypoKPP)...
  35. Im E, Lee J, Kim J, Chang S, Moon S, Ahn Y, et al. Hypokalemic periodic paralysis associated with thyrotoxicosis, renal tubular acidosis and nephrogenic diabetes insipidus. Endocr J. 2010;57:347-50 pubmed
    A 19-year-old girl presented at our emergency room with hypokalemic periodic paralysis. She had a thyrotoxic goiter and had experienced three paralytic attacks during the previous 2 years on occasions when she stopped taking antithyroid ..
  36. Sugiura Y, Makita N, Li L, Noble P, Kimura J, Kumagai Y, et al. Cold induces shifts of voltage dependence in mutant SCN4A, causing hypokalemic periodic paralysis. Neurology. 2003;61:914-8 pubmed
    The authors reported a mutation, P1158S, of the human skeletal muscle sodium channel gene (SCN4A) in a family with cold-induced hypokalemic periodic paralysis (hypoKPP) and myotonia.
  37. Ke T, Gomez C, Mateus H, Castano J, Wang Q. Novel CACNA1S mutation causes autosomal dominant hypokalemic periodic paralysis in a South American family. J Hum Genet. 2009;54:660-4 pubmed publisher
    ..These results identify a new mutation in CACNA1S and expand the spectrum of CACNA1S mutations associated with HypoPP...
  38. Maurya P, Kalita J, Misra U. Spectrum of hypokalaemic periodic paralysis in a tertiary care centre in India. Postgrad Med J. 2010;86:692-5 pubmed publisher
    ..Acute flaccid paralysis is a common neurological emergency with diverse causes and variable outcome. There is a paucity of reports documenting the spectrum of hypokalaemic paralysis in neurological practice...
  39. Maciel R, Lindsey S, Dias da Silva M. Novel etiopathophysiological aspects of thyrotoxic periodic paralysis. Nat Rev Endocrinol. 2011;7:657-67 pubmed publisher
    ..An integrated etiopathophysiological model is proposed based on molecular findings and knowledge gained from long-term follow-up of patients with TPP...
  40. Wu C, Wu Y, Lin J, Kuo S. Thyrotoxic periodic paralysis complicated by acute hypercapnic respiratory failure and ventricular tachycardia. Thyroid. 2008;18:1321-4 pubmed publisher
    Thyrotoxic hypokalemic periodic paralysis in combination with an acute episode of general flaccid paralysis and hypokalemia is common in young Asian men with hyperthyroidism...
  41. Bendahhou S, Cummins T, Griggs R, Fu Y, Ptacek L. Sodium channel inactivation defects are associated with acetazolamide-exacerbated hypokalemic periodic paralysis. Ann Neurol. 2001;50:417-20 pubmed
    A novel mutation in a family with hypokalemic periodic paralysis is described. The mutation R672S is located in the voltage sensor segment S4 of domain II in the SCN4A gene encoding the human skeletal muscle voltage-gated sodium channel...
  42. Hsieh M, Lyu R, Chang W, Chang K, Chen C, Chang H, et al. Hypokalemic thyrotoxic periodic paralysis: clinical characteristics and predictors of recurrent paralytic attacks. Eur J Neurol. 2008;15:559-64 pubmed publisher
    ..To study the clinical characteristics of hypokalemic thyrotoxic periodic paralysis (hoTPP) and identify the predictors of recurrent paralytic attacks before achieving the euthyroid status...
  43. Liu Z, Braverman L, Malabanan A. Thyrotoxic periodic paralysis in a Hispanic man after the administration of prednisone. Endocr Pract. 2006;12:427-31 pubmed
    ..To present a case of thyrotoxic periodic paralysis (TPP) in a Hispanic man and to discuss the potential precipitating mechanisms...
  44. Davies N, Eunson L, Samuel M, Hanna M. Sodium channel gene mutations in hypokalemic periodic paralysis: an uncommon cause in the UK. Neurology. 2001;57:1323-5 pubmed
    Eleven of 36 families with hypokalemic periodic paralysis (hypoPP) harbored mutations in the skeletal muscle calcium channel gene (CACNA1S). The authors screened the skeletal muscle sodium channel gene (SCN4A) in the remainder...
  45. Matthews E, Portaro S, Ke Q, Sud R, Haworth A, Davis M, et al. Acetazolamide efficacy in hypokalemic periodic paralysis and the predictive role of genotype. Neurology. 2011;77:1960-4 pubmed publisher
    Acetazolamide has been the most commonly used treatment for hypokalemic periodic paralysis since 1968. However, its mechanism of efficacy is not fully understood, and it is not known whether therapy response relates to genotype...
  46. Meyer T, Jurkat Rott K, Huebner A, Lehmann Horn F, Linke P, van Landeghem F, et al. Progressive muscle atrophy with hypokalemic periodic paralysis and calcium channel mutation. Muscle Nerve. 2008;37:120-4 pubmed
    A family with hypokalemic periodic paralysis (HypoPP) and motor neuron degeneration is reported. In conjunction with HypoPP, the index patient developed progressive muscle atrophy...
  47. Kawamura S, Ikeda Y, Tomita K, Watanabe N, Seki K. A family of hypokalemic periodic paralysis with CACNA1S gene mutation showing incomplete penetrance in women. Intern Med. 2004;43:218-22 pubmed
    Familial hypokalemic periodic paralysis is an autosomal dominant genetic muscle disease characterized by periodic attacks of muscle weakness associated with a decrease in serum potassium...
  48. Chen Y, Fang J, Chang C, Chou H. Thyrotoxic periodic paralysis in a patient abusing thyroxine for weight reduction. Ren Fail. 2001;23:139-42 pubmed
    ..We present an unusual patient with previous normal thyroid function who had abused thyroxine as antiobesity pills and developed periodic paralysis affecting the upper and lower limbs...
  49. Marchant C, Ellis F, Halsall P, Hopkins P, Robinson R. Mutation analysis of two patients with hypokalemic periodic paralysis and suspected malignant hyperthermia. Muscle Nerve. 2004;30:114-7 pubmed
    b>Hypokalemic periodic paralysis (HypoPP) and malignant hyperthermia (MH) are autosomal-dominant genetically heterogeneous ion channelopathies...
  50. Fontaine B. Periodic paralysis. Adv Genet. 2008;63:3-23 pubmed publisher
    ..Except for thyrotoxic hypokalemic periodic paralysis and periodic paralyses secondary to permanent changes of blood potassium levels, all of these diseases ..
  51. Lin S, Hsu Y, Cheng N, Kao M. Skeletal muscle dihydropyridine-sensitive calcium channel (CACNA1S) gene mutations in chinese patients with hypokalemic periodic paralysis. Am J Med Sci. 2005;329:66-70 pubmed
    ..periodic paralysis (TPP), familial periodic paralysis (FPP), and sporadic periodic paralysis (SPP) are common causes of hypokalemic periodic paralysis and have similar clinical presentations, thus possibly sharing the identical mutations.
  52. Phakdeekitcharoen B, Ruangraksa C, Radinahamed P. Hypokalaemia and paralysis in the Thai population. Nephrol Dial Transplant. 2004;19:2013-8 pubmed
    ..This syndrome may result from hypokalaemic periodic paralysis (HypoPP), thyrotoxic periodic paralysis (TPP) or distal renal tubular acidosis (dRTA). We prospectively investigated the nature of this syndrome in afflicted Thai patients...
  53. Venance S, Jurkat Rott K, Lehmann Horn F, Tawil R. SCN4A-associated hypokalemic periodic paralysis merits a trial of acetazolamide. Neurology. 2004;63:1977 pubmed
  54. Kusumi M, Kumada H, Adachi Y, Nakashima K. Muscle weakness in a Japanese family of Arg1239His mutation hypokalemic periodic paralysis. Psychiatry Clin Neurosci. 2001;55:539-41 pubmed
    Familial hypokalemic periodic paralysis is an autosomal dominant disorder. Recently, three predominant mutations were found in the muscle dihydropyridine-sensitive calcium channel alpha 1-subunit gene...
  55. Chen D, Schneider P, Zhang X, He Z, Chen T. Fatality after cardiac arrest in thyrotoxic periodic paralysis due to profound hypokalemia resulting from intravenous glucose administration and inadequate potassium replacement. Thyroid. 2012;22:969-72 pubmed publisher
    ..Here, we present a patient with TPP who developed hypokalemic paralysis that was probably aggravated by the administration of a carbohydrate, probably contributing to, if not causing, a fatal outcome...
  56. Duman O, Koyun M, Akman S, Guven A, Haspolat S. Case of Bartter syndrome presenting with hypokalemic periodic paralysis. J Child Neurol. 2006;21:255-6 pubmed
    b>Hypokalemic periodic paralysis can occur secondarily to excessive potassium loss...
  57. Kim M, Lee S, Park M, Kim B, Cho K, Lee M, et al. Mutation screening in Korean hypokalemic periodic paralysis patients: a novel SCN4A Arg672Cys mutation. Neuromuscul Disord. 2004;14:727-31 pubmed
    Familial hypokalemic periodic paralysis is an autosomal-dominant disorder with features of both genetic and phenotypic heterogeneity...
  58. Soy M, Pamuk O, Gerenli M, Celik Y. A primary Sjögren's syndrome patient with distal renal tubular acidosis, who presented with symptoms of hypokalemic periodic paralysis: Report of a case study and review of the literature. Rheumatol Int. 2005;26:86-9 pubmed
    ..Here, we shall present a 39-year-old female patient who came to us with hypokalemic periodic paralysis (HPP), and who was later diagnosed with distal RTA...
  59. Chou H, Tsao Y, Lin S. An unusual cause of thyrotoxic periodic paralysis: triiodothyronine-containing weight reducing agents. Am J Med Sci. 2009;337:71-3 pubmed publisher
    ..This is the first reported case of exogenous triiodothyronine-induced thyrotoxic periodic paralysis, which may have been precipitated by the withdrawal of propranolol...
  60. Erem C. Thyrotoxic hypokalemic periodic paralysis in a Turkish male with graves' disease: a rare case report and review of the literature. Endocrine. 2005;27:63-5 pubmed
    Thyrotoxic hypokalemic periodic paralysis (THPP) is a very rare complication of thyrotoxicosis in whites, but is more frequently reported in individuals of Asian descent...