- Limb muscle weakness: Lower extremity muscles are affected more than upper; proximal muscles are affected more than distal.
- Muscle weakness is usually symmetric.
- Muscles of the eyes, face, tongue, pharynx, larynx, diaphragm, and sphincters are rarely involved.
- Deep tendon reflexes may be hypoactive.
- Sensation is preserved.
- Strength between attacks is usually near normal.
- After years of attacks, persistent proximal weakness may be present.
- Patients with THPP may manifest signs of hyperthyroidism (especially systolic hypertension and tachycardia).
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