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July 1969

Thyrotoxic Hypokalemic Periodic Paralysis: Muscle Morphology and Functional Assay of Sarcoplasmic Reticulum

Author Affiliations

Durham, NC
From the divisions of neurology (Dr. Brody) and neuropathology (Dr. Dudley), Duke University Medical Center, Durham, NC. Dr. Dudley is now with the Department of Pathology, University of Wisconsin Medical Center, Madison, Wis.

Arch Neurol. 1969;21(1):1-6. doi:10.1001/archneur.1969.00480130015001

HYPOKALEMIC periodic paralysis may occur as a primary, familial disease or may be secondary to thyrotoxicosis. We recently observed a patient with thyrotoxic periodic paralysis who had myopathic changes compatible with thyrotoxicosis in addition to the changes characteristic of periodic paralysis. The purpose of the present report is to describe this combination of structural defects and to propose that these changes in a muscle biopsy specimen suggest the diagnosis of thyrotoxic periodic paralysis.

Report of a Case  Clinical History.—A 29-year-old white factory foreman (DU No. H26441) was admitted to the Duke University Medical Center because of an attack of weakness.The patient was in good health until 18 months before admission when he found that he could not rise from bed one morning because of weakness in his trunk and extremities. There was no pain and no excretory incontinence. Strength began to return after four hours, and by