Wu Chia-Chao, Chau Tom, Chang Chao-Jiieh, Lin Shih-Hua
Division of Nephrology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Am J Emerg Med. 2003 Jan;21(1):71-3. doi: 10.1053/ajem.2003.50005.
Hypokalemic paralysis associated with hyperthyroidism (TPP) is a well-known acute electrolyte and muscle function disorder. Lesser known is normokalemic periodic paralysis associated with hyperthyroidism. We describe two cases of young men with acute muscular paralysis and bilateral impairment of sensation over the lower legs who had normal plasma potassium concentrations. They were initially misdiagnosed as having Guillain-Barré syndrome or hysterical paralysis. However, thyroid function tests showed elevated serum T(3) and T(4) and markedly depressed thyroid-stimulating hormone findings consistent with hyperthyroidism. Control of the hyperthyroidism completely abolished their periodic paralysis. Thyrotoxic normokalemic periodic paralysis (TNPP) should be kept in mind as a cause of acute muscle weakness to avoid missing a treatable and curable condition.
甲状腺功能亢进症相关的低钾性麻痹（TPP）是一种众所周知的急性电解质和肌肉功能障碍。鲜为人知的是与甲状腺功能亢进症相关的正常血钾性周期性麻痹。我们描述了两例年轻男性病例，他们患有急性肌肉麻痹和双侧小腿感觉障碍，血浆钾浓度正常。他们最初被误诊为吉兰-巴雷综合征或癔症性麻痹。然而，甲状腺功能检查显示血清T(3)和T(4)升高，促甲状腺激素明显降低，这与甲状腺功能亢进症相符。控制甲状腺功能亢进症完全消除了他们的周期性麻痹。甲状腺毒症性正常血钾性周期性麻痹（TNPP）应被视为急性肌肉无力的一个病因，以免漏诊一种可治疗和可治愈的疾病。
