5-Minute Clinical Consult : Hypokalemic Periodic Paralysis

Hypokalemic Periodic Paralysis

Physical Exam

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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