eMedicine Specialties > Neurology > Neuromuscular Diseases

Periodic Paralyses: Follow-up

Author: Naganand Sripathi, MD, Director, Neuromuscular Clinic, Department of Neurology, Henry Ford Hospital
Contributor Information and Disclosures

Updated: Aug 26, 2009

Follow-up

Prognosis

  • Hyperkalemic periodic paralyses and paramyotonia congenita
    • When not associated with weakness, these usually do not interfere with ability to work.
    • Myotonia may require treatment.
    • Life expectancy is not known to be affected.
  • Hypokalemic periodic paralyses
    • Untreated patients may experience fixed proximal weakness, which may interfere with activities.
    • Several deaths have been reported, mostly related to aspiration pneumonia or inability to clear secretions.

Patient Education

  • Periodic Paralysis Resource Center (PPRC): This is the official Web site of the Periodic Paralysis Association.
  • Periodic Paralysis (PP): A Web site of the Muscular Dystrophy association. Articles from Quest magazine provide information regarding PP. The Research Digest link provides references on the causes and treatments.

Miscellaneous

Medicolegal Pitfalls

  • The major medicolegal risks are misdiagnosis or delayed diagnosis. However, PP can be notoriously difficult to diagnose, and typically patients have been evaluated by multiple physicians (including specialists) before the diagnosis is confirmed.
  • Adequate instruction/education should be provided to patients and their families or caregivers to ensure their safety when acute attacks occur.
 


More on Periodic Paralyses

Overview: Periodic Paralyses
Differential Diagnoses & Workup: Periodic Paralyses
Treatment & Medication: Periodic Paralyses
Follow-up: Periodic Paralyses
References
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References

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  2. Venance SL, Cannon SC, Fialho D, et al. The primary periodic paralyses: diagnosis, pathogenesis and treatment. Brain. Jan 2006;129(Pt 1):8-17. [Medline].

  3. Matthews E, Labrum R, Sweeney MG, Sud R, Haworth A, Chinnery PF, et al. Voltage sensor charge loss accounts for most cases of hypokalemic periodic paralysis. Neurology. May 5 2009;72(18):1544-7. [Medline].

  4. Arzel-Hezode M, McGoey S, Sternberg D, Vicart S, Eymard B, Fontaine B. Glucocorticoids may trigger attacks in several types of periodic paralysis. Neuromuscul Disord. Mar 2009;19(3):217-9. [Medline].

  5. Donaldson MR, Yoon G, Fu YH, Ptacek LJ. Andersen-Tawil syndrome: a model of clinical variability, pleiotropy, and genetic heterogeneity. Ann Med. 2004;36 Suppl 1:92-7. [Medline].

  6. Dias Da Silva MR, Cerutti JM, Arnaldi LA, Maciel RM. A mutation in the KCNE3 potassium channel gene is associated with susceptibility to thyrotoxic hypokalemic periodic paralysis. J Clin Endocrinol Metab. Nov 2002;87(11):4881-4. [Medline].

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  17. Lin SH, Lin YF, Chen DT, et al. Laboratory tests to determine the cause of hypokalemia and paralysis. Arch Intern Med. Jul 26 2004;164(14):1561-6. [Medline].

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  19. Meola G, Sansone V. Treatment in myotonia and periodic paralysis. Rev Neurol (Paris). May 2004;160(5 Pt 2):S55-69. [Medline].

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Further Reading

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Keywords

periodic paralysis, hypokalemia, hyperkalemia, myotonia, paramyotonia congenita, potassium-aggravated myotonia, voltage-sensitive ion channels, voltage-gated ion channels, channelopathy, calcium channels, sodium channels, chloride channels, thyrotoxicosis, periodic paralyses, PP

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Contributor Information and Disclosures

Author

Naganand Sripathi, MD, Director, Neuromuscular Clinic, Department of Neurology, Henry Ford Hospital
Naganand Sripathi, MD is a member of the following medical societies: American Academy of Neurology, American Medical Association, Michigan State Medical Society, and New York Academy of Sciences
Disclosure: Nothing to disclose.

Medical Editor

Paul E Barkhaus, MD, Professor, Department of Neurology, Medical College of Wisconsin; Director of Neuromuscular Diseases, Milwaukee Veterans Administration Medical Center
Paul E Barkhaus, MD is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, and American Neurological Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Glenn Lopate, MD, Associate Professor, Department of Neurology, Division of Neuromuscular Diseases, Washington University School of Medicine; Chief of Neurology, St Louis ConnectCare, Consulting Staff, Barnes Jewish Hospital
Glenn Lopate, MD is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, and Phi Beta Kappa
Disclosure: Nothing to disclose.

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Nicholas Lorenzo, MD, Chief Editor, eMedicine Neurology; Consulting Staff, Neurology Specialists and Consultants
Nicholas Lorenzo, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Neurology
Disclosure: Nothing to disclose.

 
 
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