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J Transl Med. 2008 Apr 21;6:18. doi: 10.1186/1479-5876-6-18.

Practical aspects in the management of hypokalemic periodic paralysis.

Erratum in

  • J Transl Med. 2014;12:198. Dosage error in article text.

Abstract

Management considerations in hypokalemic periodic paralysis include accurate diagnosis, potassium dosage for acute attacks, choice of diuretic for prophylaxis, identification of triggers, creating a safe physical environment, peri-operative measures, and issues in pregnancy. A positive genetic test in the context of symptoms is the gold standard for diagnosis. Potassium chloride is the favored potassium salt given at 0.5-1.0 mEq/kg for acute attacks. The oral route is favored, but if necessary, a mannitol solvent can be used for intravenous administration. Avoidance of or potassium prophylaxis for common triggers, such as rest after exercise, high carbohydrate meals, and sodium, can prevent attacks. Chronically, acetazolamide, dichlorphenamide, or potassium-sparing diuretics decrease attack frequency and severity but are of little value acutely. Potassium, water, and a telephone should always be at a patient's bedside, regardless of the presence of weakness. Perioperatively, the patient's clinical status should be checked frequently. Firm data on the management of periodic paralysis during pregnancy is lacking. Patient support can be found at http://www.periodicparalysis.org.

PMID:
18426576
PMCID:
PMC2374768
DOI:
10.1186/1479-5876-6-18
[PubMed - indexed for MEDLINE]
Free PMC Article
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