Hypokalemic periodic paralysis - Revision history

Kfarzam: /* Management */

2022-08-20T05:27:45Z

Management

← Revisión anterior		Revisión del 05:27 20 ago 2022
Línea 47:		Línea 47:
	==Management==		==Management==
	*Replace potassium appropriately - do not try to correct to normal level as once the muscles release potassium you will likely overcorrect		*Replace potassium appropriately - do not try to correct to normal level as once the muscles release potassium you will likely overcorrect
			*Consider magnesium
	*Consider [[propranolol]] 3 mg/kg PO, expect to see rise in potassium within 2 hours<ref>Lin SH and Lin YF. Propranolol rapidly reverses paralysis, hypokalemia, and hypophosphatemia in thyrotoxic periodic paralysis. Am J Kidney Dis. 2001 Mar;37(3):620-3.</ref>		*Consider [[propranolol]] 3 mg/kg PO, expect to see rise in potassium within 2 hours<ref>Lin SH and Lin YF. Propranolol rapidly reverses paralysis, hypokalemia, and hypophosphatemia in thyrotoxic periodic paralysis. Am J Kidney Dis. 2001 Mar;37(3):620-3.</ref>
	**Only in hemodynamically stable patients without significant conduction block		**Only in hemodynamically stable patients without significant conduction block

ClaireLewis at 01:36, 2 September 2019

2019-09-02T01:36:14Z

← Revisión anterior		Revisión del 01:36 2 sep 2019
Línea 6:		Línea 6:
	*There is no decrease in total body potassium. Blood potassium level is normal between attacks.<ref>Mount DB, Zandi-Nejad K. Disorders of potassium balance. In Taal MW, Chertow GM, Marsden PA, et al., eds. Brenner and Rector’s The Kidney. 9th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 17.</ref>		*There is no decrease in total body potassium. Blood potassium level is normal between attacks.<ref>Mount DB, Zandi-Nejad K. Disorders of potassium balance. In Taal MW, Chertow GM, Marsden PA, et al., eds. Brenner and Rector’s The Kidney. 9th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 17.</ref>
	*Associations		*Associations
	**Thyrotoxicosis (thyrotoxicosis periodic paralysis)		**[[Thyrotoxicosis]] (thyrotoxicosis periodic paralysis)
	**Steroids		**[[Steroids]]
	**ETOH		**[[ETOH]]
	**Renal disease		**Renal disease

	==Clinical Features==		==Clinical Features==
	===Symptoms===		===Symptoms===
	*Muscle weakness or paralysis with associated hypokalemia (though potassium levels can be normal)		*Muscle [[weakness]] or paralysis with associated hypokalemia (though potassium levels can be normal)
	*Sometimes painful though often painless		*Sometimes [[myalgia\|painful]] though often painless
	*Weakness can be from hand to leg to complete paralysis		*Weakness can be from hand to leg to complete paralysis
	===History===		===History===
Línea 36:		Línea 36:
	*Chemistry (potassium)		*Chemistry (potassium)
	*Magnesium		*Magnesium
	*~~TFTs~~ for first presentation		*Thyroid function tests for first presentation

	===ECG Findings===		===ECG Findings===
	*Sinus bradycardia		*Sinus [[bradycardia]]
	*[[ECG]] signs of hypokalemia may be present but not always diagnostic<ref>Hypokalemic Periodic Paralysis. Periodic Paralysis International. http://hkpp.org/physicians/hypokalemic_pp</ref>		*[[ECG]] signs of hypokalemia may be present but not always diagnostic<ref>Hypokalemic Periodic Paralysis. Periodic Paralysis International. http://hkpp.org/physicians/hypokalemic_pp</ref>
	**U waves in leads II, V-2, V-3, and V-4		**U waves in leads II, V-2, V-3, and V-4
Línea 47:		Línea 47:
	==Management==		==Management==
	*Replace potassium appropriately - do not try to correct to normal level as once the muscles release potassium you will likely overcorrect		*Replace potassium appropriately - do not try to correct to normal level as once the muscles release potassium you will likely overcorrect
	*Consider propranolol 3 mg/kg PO, expect to see rise in potassium within 2 hours<ref>Lin SH and Lin YF. Propranolol rapidly reverses paralysis, hypokalemia, and hypophosphatemia in thyrotoxic periodic paralysis. Am J Kidney Dis. 2001 Mar;37(3):620-3.</ref>		*Consider [[propranolol]] 3 mg/kg PO, expect to see rise in potassium within 2 hours<ref>Lin SH and Lin YF. Propranolol rapidly reverses paralysis, hypokalemia, and hypophosphatemia in thyrotoxic periodic paralysis. Am J Kidney Dis. 2001 Mar;37(3):620-3.</ref>
	**Only in hemodynamically stable patients without significant conduction block		**Only in hemodynamically stable patients without significant conduction block
	**Beta blockers particularly helpful in thyrotoxicosis variant		**Beta blockers particularly helpful in thyrotoxicosis variant

Josgood: /* Background */

2018-12-08T19:43:00Z

Background

← Revisión anterior		Revisión del 19:43 8 dic 2018
Línea 1:		Línea 1:
	==Background==		==Background==
	*Autosomal dominant channelopathy<ref>June-Bum Kim, MD, PhD. Channelopathies. Korean J Pediatr. 2014 Jan;57(1):1-18 [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935107/ Full Text]</ref>		*Autosomal dominant channelopathy<ref>June-Bum Kim, MD, PhD. Channelopathies. Korean J Pediatr. 2014 Jan;57(1):1-18 [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935107/ Full Text]</ref>
	*Acquired hypokalemia from barium poisoning, hyperthyroidism, renal disorders, and GI losses<ref>Ahlawat SK and Sachdev A. Hypokalemic paralysis. Postgrad Med J. 1999; 75(882):193-197.</ref>		*Acquired [[hypokalemia]] from barium poisoning, hyperthyroidism, renal disorders, and GI losses<ref>Ahlawat SK and Sachdev A. Hypokalemic paralysis. Postgrad Med J. 1999; 75(882):193-197.</ref>
	*Most first attacks happen by age 16		*Most first attacks happen by age 16
	*Young males, Asian		*Young males, Asian

Kxl328: /* Management */

2018-11-07T01:06:55Z

Management

← Revisión anterior		Revisión del 01:06 7 nov 2018
Línea 48:		Línea 48:
	*Replace potassium appropriately - do not try to correct to normal level as once the muscles release potassium you will likely overcorrect		*Replace potassium appropriately - do not try to correct to normal level as once the muscles release potassium you will likely overcorrect
	*Consider propranolol 3 mg/kg PO, expect to see rise in potassium within 2 hours<ref>Lin SH and Lin YF. Propranolol rapidly reverses paralysis, hypokalemia, and hypophosphatemia in thyrotoxic periodic paralysis. Am J Kidney Dis. 2001 Mar;37(3):620-3.</ref>		*Consider propranolol 3 mg/kg PO, expect to see rise in potassium within 2 hours<ref>Lin SH and Lin YF. Propranolol rapidly reverses paralysis, hypokalemia, and hypophosphatemia in thyrotoxic periodic paralysis. Am J Kidney Dis. 2001 Mar;37(3):620-3.</ref>
	**Only in hemodynamically stable patients		**Only in hemodynamically stable patients without significant conduction block
	**Beta blockers particularly helpful in thyrotoxicosis variant		**Beta blockers particularly helpful in thyrotoxicosis variant
	*Long Term Treatment:		*Long Term Treatment:

Kxl328: /* Management */

2018-11-07T01:06:14Z

Management

← Revisión anterior		Revisión del 01:06 7 nov 2018
Línea 47:		Línea 47:
	==Management==		==Management==
	*Replace potassium appropriately - do not try to correct to normal level as once the muscles release potassium you will likely overcorrect		*Replace potassium appropriately - do not try to correct to normal level as once the muscles release potassium you will likely overcorrect
			*Consider propranolol 3 mg/kg PO, expect to see rise in potassium within 2 hours<ref>Lin SH and Lin YF. Propranolol rapidly reverses paralysis, hypokalemia, and hypophosphatemia in thyrotoxic periodic paralysis. Am J Kidney Dis. 2001 Mar;37(3):620-3.</ref>
			**Only in hemodynamically stable patients
			**Beta blockers particularly helpful in thyrotoxicosis variant
	*Long Term Treatment:		*Long Term Treatment:
	**Should be initiated by primary physician but often includes eating a low carbohydrate diet and avoiding alcohol		**Should be initiated by primary physician but often includes eating a low carbohydrate diet and avoiding alcohol

Kxl328: /* Labs */

2018-11-02T21:07:36Z

Labs

← Revisión anterior		Revisión del 21:07 2 nov 2018
Línea 35:		Línea 35:
	===Labs===		===Labs===
	*Chemistry (potassium)		*Chemistry (potassium)
			*Magnesium
			*TFTs for first presentation

	===ECG Findings===		===ECG Findings===

Kxl328: /* Background */

2018-11-02T21:07:04Z

Background

← Revisión anterior		Revisión del 21:07 2 nov 2018
Línea 6:		Línea 6:
	*There is no decrease in total body potassium. Blood potassium level is normal between attacks.<ref>Mount DB, Zandi-Nejad K. Disorders of potassium balance. In Taal MW, Chertow GM, Marsden PA, et al., eds. Brenner and Rector’s The Kidney. 9th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 17.</ref>		*There is no decrease in total body potassium. Blood potassium level is normal between attacks.<ref>Mount DB, Zandi-Nejad K. Disorders of potassium balance. In Taal MW, Chertow GM, Marsden PA, et al., eds. Brenner and Rector’s The Kidney. 9th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 17.</ref>
	*Associations		*Associations
	**Thyrotoxicosis		**Thyrotoxicosis (thyrotoxicosis periodic paralysis)
	**Steroids		**Steroids
	**ETOH		**ETOH

Rossdonaldson1: Text replacement - "ECG" to "ECG"

2016-09-09T09:56:05Z

Text replacement - "*ECG" to "*ECG"

← Revisión anterior		Revisión del 09:56 9 sep 2016
Línea 38:		Línea 38:
	===ECG Findings===		===ECG Findings===
	*Sinus bradycardia		*Sinus bradycardia
	*ECG signs of hypokalemia may be present but not always diagnostic<ref>Hypokalemic Periodic Paralysis. Periodic Paralysis International. http://hkpp.org/physicians/hypokalemic_pp</ref>		*[[ECG]] signs of hypokalemia may be present but not always diagnostic<ref>Hypokalemic Periodic Paralysis. Periodic Paralysis International. http://hkpp.org/physicians/hypokalemic_pp</ref>
	**U waves in leads II, V-2, V-3, and V-4		**U waves in leads II, V-2, V-3, and V-4
	**Progressive flattening of T waves and depression of ST segment		**Progressive flattening of T waves and depression of ST segment

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-23T19:53:51Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Revisión anterior		Revisión del 19:53 23 jul 2016
Línea 32:		Línea 32:
	{{Weakness DDX}}		{{Weakness DDX}}

	==~~Diagnosis~~==		==Evaluation==
	===Labs===		===Labs===
	*Chemistry (potassium)		*Chemistry (potassium)

Neil.m.young at 15:55, 18 May 2016

2016-05-18T15:55:16Z

← Revisión anterior		Revisión del 15:55 18 may 2016
Línea 36:		Línea 36:
	*Chemistry (potassium)		*Chemistry (potassium)

	===~~EKG~~ Findings===		===ECG Findings===
	*Sinus bradycardia		*Sinus bradycardia
	*~~Electrocardiographic (~~ECG) signs of hypokalemia may be present but not always diagnostic<ref>Hypokalemic Periodic Paralysis. Periodic Paralysis International. http://hkpp.org/physicians/hypokalemic_pp</ref>		*ECG signs of hypokalemia may be present but not always diagnostic<ref>Hypokalemic Periodic Paralysis. Periodic Paralysis International. http://hkpp.org/physicians/hypokalemic_pp</ref>
	**U waves in leads II, V-2, V-3, and V-4		**U waves in leads II, V-2, V-3, and V-4
	**Progressive flattening of T waves and depression of ST segment		**Progressive flattening of T waves and depression of ST segment

Hypokalemic periodic paralysis - Revision history

Kfarzam: /* Management */

ClaireLewis at 01:36, 2 September 2019

Josgood: /* Background */

Kxl328: /* Management */

Kxl328: /* Management */

Kxl328: /* Labs */

Kxl328: /* Background */

Rossdonaldson1: Text replacement - "*ECG" to "*ECG"

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

Neil.m.young at 15:55, 18 May 2016

Rossdonaldson1: Text replacement - "ECG" to "ECG"