Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines - Manila, Taft Avenue, Ermita, Manila 1000, Philippines.
Department of Neurosciences, College of Medicine and Philippine General Hospital, University of the Philippines - Manila, Taft Avenue, Ermita, Manila 1000, Philippines.
J Clin Neurosci. 2019 Dec;70:254-257. doi: 10.1016/j.jocn.2019.08.063. Epub 2019 Aug 19.
Hypokalemic periodic paralysis secondary to distal renal tubular acidosis presenting with prominent bulbar symptoms is extremely rare. The exact pathophysiology by which hypokalemia causes weakness is yet to be elucidated though muscle and nerve membrane hyperpolarization have been hypothesized. The pathophysiology of bulbar involvement in this condition is even more unclear. We report a case presenting as acute flaccid quadriplegia with prominent bulbar symptoms that reversed once potassium levels returned to normal. Serial nerve conduction studies were performed at various potassium levels revealing electrophysiologic abnormalities that corrected with potassium repletion. A systematic review of the literature was also conducted focusing on bulbar symptoms and electrophysiologic findings in hypokalemic periodic paralysis. Nerve conduction abnormalities in this condition are seldom documented, but reports have shown reduced amplitudes of compound motor action potentials and abnormal F-waves during acute attacks of hypokalemic paralysis.
低钾性周期性麻痹继发于远端肾小管酸中毒，以显著球部症状为表现者极为罕见。虽然已经假设肌肉和神经膜超极化，但低钾血症导致无力的确切病理生理学仍未阐明。这种情况下球部受累的病理生理学甚至更不清楚。我们报告了一例以急性弛缓性四肢瘫痪为表现，伴有显著球部症状的病例，一旦血钾水平恢复正常，症状即逆转。在不同血钾水平下进行了一系列神经传导研究，结果显示存在电生理异常，补充钾后得到纠正。还对文献进行了系统回顾，重点关注低钾性周期性麻痹的球部症状和电生理发现。在这种情况下很少有神经传导异常的报道，但有报道显示在低钾性麻痹急性发作时复合运动动作电位幅度降低和 F 波异常。
