Braun Christian T, Srivastava David S, Engelhardt Bianca Maria, Lindner Gregor, Exadaktylos Aristomenis K
Department of Emergency Medicine, Inselspital, University Hospital Bern, Freiburgstrasse, 3010 Bern, Switzerland.
Department of Surgery, Inselspital, University Hospital Bern, Freiburgstrasse, 3010 Bern, Switzerland.
Case Rep Emerg Med. 2014;2014:160396. doi: 10.1155/2014/160396. Epub 2014 Nov 25.
A 58-year-old male patient was admitted to our emergency department at a large university hospital due to acute onset of general weakness. It was reported that the patient was bradycardic at 30/min and felt an increasing weakness of the limbs. At admission to the emergency department, the patient was not feeling any discomfort and denied dyspnoea or pain. The primary examination of the nervous system showed the cerebral nerves II-XII intact, muscle strength of the lower extremities was 4/5, and a minimal sensory loss of the left hemisphere was found. In addition, the patient complained about lazy lips. During ongoing examinations, the patient developed again symptomatic bradycardia, accompanied by complete tetraplegia. The following blood test showed severe hyperkalemia probably induced by use of aldosterone antagonists as the cause of the patient's neurologic symptoms. Hyperkalemia is a rare but treatable cause of acute paralysis that requires immediate treatment. Late diagnosis can delay appropriate treatment leading to cardiac arrhythmias and arrest.
一名58岁男性患者因突然出现全身无力而被收入一所大型大学医院的急诊科。据报告，该患者心率缓慢，每分钟30次，且感到四肢无力逐渐加重。在进入急诊科时，患者没有感到任何不适，否认有呼吸困难或疼痛。神经系统初步检查显示，脑神经II - XII完好，下肢肌力为4/5，左半球有轻微感觉丧失。此外，患者抱怨嘴唇无力。在持续检查过程中，患者再次出现症状性心动过缓，并伴有完全性四肢瘫痪。随后的血液检查显示，严重高钾血症可能是由使用醛固酮拮抗剂引起的，这是患者神经症状的原因。高钾血症是急性瘫痪的一种罕见但可治疗的病因，需要立即治疗。延迟诊断会导致适当治疗延误，进而引发心律失常和心脏骤停。
