How To Confirm The Diagnosis Of Hypokalemic Periodic Paralysis?

Posted on Sat, 2 Jul 2016

Question: Are there any other diagnostic tools available to help confirm a diagnosis of the Temporary Periodic Paralysis'. My doctor only knew of the muscle biopsy and the insurance rejected it because it is too expensive. He suggested hypokalemic . But , I dont know if my carb intake is enough to trigger it,especially when it can cause paralysis up to 48 hours later. Do you have any advice?

Can my sensory, motor, polyneuropathy, i have had for 4 years cause this? Also, low blood sugar can trigger difficulty walking and i use sugar to prevent it when i feel the stiffness numb feeling coming on.

Answered by Dr. Neeraj Kumar (15 minutes later)

Brief Answer:
Provide more details and reports if available

Detailed Answer:
Hello,
I have gone through your question and understand your concerns.
Hypokalemic periodic paralysis is caused by low potassium due to causes like diarrhoea, renal disease, vomiting, diuretic use, hyperthyroidism or idiopathic.
The paralysis is for few hours to days but recovers with normalised potassium. There is hardly any residual weakness or changes on nerve conduction after recovery. Neuropathy is uncommonly persistent.
What are your symptoms?
Is your weakness episodes last for days?
Any precipitating cause?
Any previous investigations done?
The diagnosis can be made by investigating at the time of episodes. If all work up have already been done and genetic channelopathy is suspected then gene testing is required which is costly and available as research tools.
Hope you found the answer helpful.
Do get back to me for further queries with reports and details.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Neeraj Kumar (1 hour later)

I had 23 blood tests to rule out everything under the sun. There is no cause other than the suspected low potassium problem . My potassium generally averages 4.0 out of like 15 hospitalizations. i need to get another blood test result at a university hospital when i was very weak and heart pain. This was last year.I will send you reports as soon as i can if that is ok.
my symtoms are that when i wake up I can not move at all. Just softly speak and blink. It used to last 3 hours and resolved completely at 6 hours. Last year it was a result of taking requip and hydrocodone at the same time. Sleep triggers it or that is when it occurs, at rest. I am aware the whole time. it is like my body is asleep and my brain awake and i have to go to the bathroom and i cant unless someone moves my legs a bit and then leads me there. It lasts until i can get help. I am completely paralized and cannot move anything. But i focus on a toe or hand until eventually, after minutes i can slowly add more parts of my limbs until i can get up. These lesser attacks last for minutes.

Answered by Dr. Neeraj Kumar (9 hours later)

Brief Answer:
Get evaluated for recurrent isolated sleep paralysis and narcolepsy

Detailed Answer:
Hello,
The potassium levels are in normal range.
A close possibility may be recurrent isolated sleep paralysis (RISP) characterised by paralysis on awakening lasting for seconds to minutes and uncommonly hours. Second possibility may be narcolepsy.
You need to visit a neurologist or sleep expert get polysomnography done.
For treatment you can take amitryptiline, sertraline.
Sleep habits to be improved by regular timing, avoiding late awakening, avoiding tea or coffee in night. Meditation can also be helpful.
Upload any reports and prescription if available.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Sonia Raina