低钾性周期性麻痹作为甲状腺毒症的一种表现。

Division of Neurology, Department of Medicine, Ratchaburi Hospital, Ratchaburi 70000, Thailand.

J Med Assoc Thai. 2008 Sep;91(9):1331-5.

OBJECTIVE

To study the clinical characteristics of patients who suffer from hypokalemic periodic paralysis, as the presenting symptoms of thyrotoxicosis.

MATERIAL AND METHOD

A retrospective review of 29 patients who presented with the syndrome of hypokalemic periodic paralysis as the symptom of thyrotoxicosis at Ratchaburi Hospital between January 1,1995 and December 31, 2007. Patients'data, diagnosis, blood chemistry, and thyroid function test were collected from medical records.

RESULTS

All patients exhibited muscle weakness for a duration of one to two days, while all patients with hypokalemic periodic paralysis were determined to have high serum thyroid hormone and diagnosed with thyrotoxicosis. Patients with hypokalemic periodic paralysis were the first symptom leading to diagnosis of thyrotoxicosis. The attack of weakness occurred during the night in all patients. The patients, 96.6% being male, showed improvement of their symptoms through potassium replacement and thyrotoxicosis treatment using propylthiouracil and non selective beta adrenergic blocker All patients recovered and did not demonstrate reoccurring hypokalemic periodic paralysis. The degree of muscle weakness was found to correlate significantly (p < 0.05) with level of serum potassium, magnesium, and duration of weakness.

CONCLUSION

It is important to determine blood thyroid hormone in all patients with hypokalemic periodic paralysis.

目的

研究以低钾性周期性麻痹为首发症状的甲状腺毒症患者的临床特征。

材料与方法

回顾性分析1995年1月1日至2007年12月31日在叻武里医院以低钾性周期性麻痹为甲状腺毒症症状就诊的29例患者。从病历中收集患者数据、诊断、血液生化及甲状腺功能检查结果。

结果

所有患者肌无力持续1至2天，所有低钾性周期性麻痹患者血清甲状腺激素均升高，诊断为甲状腺毒症。低钾性周期性麻痹是导致甲状腺毒症诊断的首发症状。所有患者肌无力发作均在夜间。患者中96.6%为男性，通过补钾及使用丙硫氧嘧啶和非选择性β肾上腺素能阻滞剂治疗甲状腺毒症，症状改善。所有患者均康复，未再出现低钾性周期性麻痹。发现肌无力程度与血清钾、镁水平及肌无力持续时间显著相关（p<0.05）。