Haddad M and Harris T
Background: Thyrotoxic periodic paralysis (TPP) is one of rare group of disorders called periodic paralysis. The usual presentation is lower limb weakness attributed to an intracellular shift of potassium. When the presentation is accompanied by increased thyroid hormone level the diagnosis of TPP can be made, and the treatment of acute attacks should be targeting hyperthyroidism with beta-blocker and antithyroid drugs, in addition to replacement of serum potassium with cautions. Cardiac arrhythmias are one of the possible complications that can occurs with tachyarrhythmias most commonly associated with TPP. Case presentation: We report a case of an Asian male who presented with bilateral lower limb weakness, his venous blood gas showed sever hypokalaemia and quickly developed bradycardia followed by cardiac arrest. The patient later found to have thyrotoxicosis and diagnosed with TTP. Conclusion: The diagnosis of TPP is often delayed due to similar presentation with familial periodic paralysis. The treating physician should have a low threshold for measuring the thyroid hormones. A patient with TPP can have variable arrhythmias with tachyarrhythmias being most common, but bradyarrhythmia can happen as with our case.
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