Thyrotoxic Periodic Paralysis: Report of 10 Cases and Review of Electromyographic Findings
Abstract
• We reviewed the clinical characteristics of 10 patients with thyrotoxic periodic paralysis. In these patients, a relatively uniform group of young men, the periodic paralysis developed nearly concurrently with the onset of hyperthyroidism. The attacks were precipitated most frequently by rest and by exercise and, occasionally, by ingestion of a large carbohydrate load. In each patient, the paralysis resolved on return of euthyroidism. The approximate incidence rate for thyrotoxic periodic paralysis in our largely white North American patient population (all hyperthyroidism cases) ranged from 0.1% to 0.2%, which is one tenth the rate reported for Oriental populations. In 7 patients, electrodiagnostic testing revealed characteristic changes in compound muscle action potential amplitude in response to exercise of the muscle being tested. (Arch Intern Med. 1989;149:2597-2600)
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Previous reports indicate that nearly 50% of TPP patients had only subtle signs/symptoms of thyrotoxicosis, without systematic assessment.
“According to previous reports, nearly 50% of TPP patients had only subtle signs/symptoms of thyrotoxicosis, albeit without systematic assessment (14, 15, 16, 36).”
From A 10-year analysis of thyrotoxic periodic paralysis in 135 patients: focus on symptomatology and precipitants (2013) · cites this paper as [15]
Typical clinical symptoms of thyrotoxicosis may be subtle and periodic paralysis may precede these symptoms in TPP.
“It is often stated in the literature that typical clinical symptoms of thyrotoxicosis, such as weight loss, heat intolerance, palpitations, increased appetite, excitability, and diaphoresis, may be subtle and periodic paralysis may precede these symptoms in TPP (10, 14, 15, 16).”
From A 10-year analysis of thyrotoxic periodic paralysis in 135 patients: focus on symptomatology and precipitants (2013) · cites this paper as [15]
The incidence of TPP in North Americans is 0.1%-0.2%.
“The incidence of TPP in Chinese and Japanese thyrotoxic patients has been reported at 1.8% and 1.9%, respectively [2], whereas in North Americans at 0.1%–0.2% [5].”
From Thyrotoxic Periodic Paralysis: Clinical Challenges (2014) · cites this paper as [5]
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Abouzahir, A., Amezyane, T., Hammi, S., Badaoui, M., Mahassin, F., & Ohayon, V. (2009) · La Presse Médicale · doi:10.1016/j.lpm.2008.07.024 · Cited by 2 · see citing works
Thyrotoxic Periodic Paralysis- A Diagnostically Challenging Rare Clinical Entity
Gadela, N. V., Madgula, A. S., Drekolias, D., Paravathaneni, M., & Modi, V. I. (2020) · Cureus · doi:10.7759/cureus.11804 · Cited by 2 · see citing works
Muscle channelopathies: periodic paralyses and nondystrophic myotonias
Ralph, J. W., & Ptáček, L. J. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-813866-3.00031-x · Cited by 2 · see citing works
- Authors
- Kelley, D. E.
- Corresponding author
- Kelley, David E.
- ORCID
- Kelley, David E.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 1989-11-01
- Volume
- 149
- Issue
- 11
- Pages
- 2597
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W4237898583
- Cited by
- 158
- References
- 0
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 6 · 2023: 4 · 2022: 2 · 2021: 5 · 2020: 9 · 2019: 6 · 2018: 4 · 2017: 1 · 2016: 4 · 2015: 6 · 2014: 6 · 2013: 8 · 2012: 11
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Potassium and Related Disorders
- Keywords
- thyrotoxic periodic paralysis, hyperthyroidism, carbohydrate loading, incidence, compound muscle action potential, electrodiagnostic testing, young men
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