Thyrotoxic Periodic Paralysis - Illness Script
• Epidemiology: Asian men age 20-30 with hyperthyroidism of any etiology
• Trigger: Heavy exercise, fasting, high-carb meals, stress, cold exposure, infection, alcohol, pulse corticosteroid therapy, albuterol, and menses
• Pathophysiology: Channelopathy due to hypersensitization of the Na-K pump by excess thyroid hormone
• Symptoms/signs: Episodes of sudden onset painless muscle weakness that are infrequent, hours-days duration +/- symptoms of thyrotoxicosis
• Labs/lmaging: Hypokalemia +/- low TSH with high fT4 or high T3
• Treatment: Potassium and magnesium repletion, Avoid triggers, Treat hyperthyroidism, Potassium supplements and propranolol for prevention of future episodes
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