PDF(Pubmed)
Abstract：
Thyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism that manifests as painless flaccid paralysis. An East Asian man in his late 20s presented to the emergency department with an acute onset of quadriparesis associated with hypertonia and hyperreflexia. His initial symptoms and signs suggested involvement of the brain and spinal cord; however, MRI of the neuroaxis was normal. His serum potassium concentration was low, and thyroid test results were consistent with hyperthyroidism. The patient was diagnosed with TPP associated with Graves\' disease and was treated with potassium supplementation, propranolol and methimazole. Motor strength improved to his baseline level of power; bulk was normal, and tone was increased. Although flaccid paralysis is a typical presentation of TPP, brisk reflexes and muscle spasticity cannot rule out this condition. This case highlights the importance of considering TPP as a possible diagnosis in patients presenting with acute quadriparesis.
摘要：
甲状腺毒性周期性麻痹（TPP）是甲状腺功能亢进的一种罕见并发症，表现为无痛性弛缓性麻痹。一名20多岁的东亚男子出现在急诊科，患有与高张力和反射亢进相关的四肢轻瘫。他最初的症状和体征表明大脑和脊髓受累；然而，神经轴MRI正常。他的血清钾浓度很低,甲状腺检查结果与甲亢一致。患者被诊断为与Graves病相关的TPP，并接受补钾治疗，普萘洛尔和甲氧咪唑.运动强度提高到他的基线功率水平；体积正常，语气增加了。虽然弛缓性麻痹是TPP的典型表现,反应灵敏和肌肉痉挛不能排除这种情况。该病例强调了将TPP视为急性四肢瘫痪患者可能诊断的重要性。
