Katabi Abdulrahman, Ottaviano Pedro
Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, USA.
Pulmonary Critical Care, Joan C. Edwards School of Medicine, Marshall University, Huntington, USA.
Cureus. 2020 Mar 9;12(3):e7227. doi: 10.7759/cureus.7227.
We are presenting a case of hypokalemic paralysis in a patient who presented to the emergency department (ED) with a unique clinical picture that did not fully fit with other causes of periodic paralysis (hypokalemic periodic paralysis, thyrotoxic periodic paralysis, hyperkalemic periodic paralysis, and Anderson syndrome). The patient presented to the ED complaining of two days of severe flaccid paralysis in both legs and left arm; his right arm was completely normal. Initially, he was treated as a stroke alert patient and had head and spine computed tomography (CT) scans and both showed no acute pathologic changes. Initial labs showed a potassium level of 1.9 and a magnesium level of 1.8. Electrocardiography (EKG) showed prolonged QTc of 534 ms. The patient was admitted to the ICU and started on intravenous and oral potassium replacement. Over the next 24 hours, he started to regain his muscle power gradually until it came back to his baseline. Repeat EKG also showed QTc back to normal. We compared our patient's initial presentation to other published case reports with periodic paralysis and found that his initial presentation was different than other published cases.
我们正在介绍一例低钾性麻痹患者，该患者因独特的临床表现前往急诊科就诊，其临床表现与其他周期性麻痹病因（低钾性周期性麻痹、甲状腺毒症性周期性麻痹、高钾性周期性麻痹和安德森综合征）并不完全相符。该患者前往急诊科，主诉双腿和左臂出现两天严重的弛缓性麻痹；其右臂完全正常。最初，他被当作中风预警患者进行治疗，并进行了头部和脊柱计算机断层扫描（CT），结果均未显示急性病理改变。初始实验室检查显示血钾水平为1.9，血镁水平为1.8。心电图（EKG）显示QTc延长至534毫秒。该患者被收入重症监护病房，并开始静脉和口服补钾治疗。在接下来的24小时内，他逐渐恢复肌肉力量，直至恢复到基线水平。复查心电图也显示QTc恢复正常。我们将该患者的初始表现与其他已发表的周期性麻痹病例报告进行了比较，发现其初始表现与其他已发表病例不同。
