An unusual presentation of hypokalemic paralysis with evolving pure motor hemiparesis

Lu, Yanting; Lan, Min‐Yu; Liu, Jiashou; Chen, Wei-Hsi

doi:10.1016/j.jocn.2010.07.145

Cited by 9 publications

(4 citation statements)

References 8 publications

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“…Hypokalemic paralysis can manifest as acute flaccid paralysis with areflexia and ascending paralysis, as seen in Guillain-Barré syndrome [18]. A case report of a 52-year-old man with HPP highlighted that potassium supplementation could reverse quadriparesis due to hypokalemia [19]. Direct damage to nerve tissue from high-voltage electrical injuries and secondary complications of tissue edema, ischemia, and necrosis can also induce neurological deficits [3].…”

Section: Discussionmentioning

confidence: 99%

The Silent Threat of Hypokalemia after High Voltage Electrical Injuries: A Case Study and Review of the Literature

Baker,

Binda,

Nozari

et al. 2024

JCM

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High-voltage electrical injuries, especially from lightning strikes, can cause life-threatening complications due to extreme temperature and voltage exposure. While burns and cardiac complications have been widely described, the documentation of metabolic imbalances, particularly hypokalemia, has not been as prevalent. This report focuses on a patient with profound transient hypokalemia following a lightning strike, alongside a review of three similar cases of transient hypokalemia from the literature. Our patient, a previously healthy young man, was struck by lightning and subsequently suffered transient hypokalemia with lower extremity sensory changes, which resolved after the normalization of serum potassium levels. While the exact underlying mechanisms of transient hypokalemia following high-voltage electrical injuries are unknown, we propose a multifactorial mechanism, which includes massive intracellular shifts of potassium due to elevated epinephrine levels and the prevention of potassium efflux through the electrical disruption of voltage-gated potassium channels. Our report underscores the importance of recognizing hypokalemia in patients with high-voltage electrical injuries and contributes to the understanding of the complex mechanisms involved. Further research is necessary to understand the connection between cellular changes induced by high-voltage exposure and their effects on metabolism, particularly in relation to hypokalemia.

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Section: Discussionmentioning

confidence: 99%

The Silent Threat of Hypokalemia after High Voltage Electrical Injuries: A Case Study and Review of the Literature

Baker,

Binda,

Nozari

et al. 2024

JCM

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“…In three of the case reports, the patients had sudden-onset right-sided weakness. [11][12][13] Another patient also developed sudden onset of right-sided weakness which was associated with right facial Plasma renin activity 1.9 ng/mL/hr 0.7-3.3 Aldosterone-to-renin ratio 6.8 ng/dL per ng/mL/hr <20 droop and dysarthria. 14 This atypical manifestation of hypokalaemic paralysis can be misdiagnosed as acute stroke especially in individuals who have comorbid cardiovascular risk factors just as our patient did.…”

Section: Discussionmentioning

confidence: 99%

An unusual stroke mimic: A case report

Adjei,

Amponsah,

Atenebano

2023

SAGE Open Medical Case Reports

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Hypokalaemic paralysis is a rare disorder characterized by rapid onset of symmetrical flaccid skeletal muscle weakness in the presence of reduced serum potassium levels. It is categorized as primary or secondary depending on the aetiology. Asymmetric or unilateral muscle weakness in hypokalaemic patients is a rare presentation. In patients with comorbid cardiovascular risk factors, this atypical manifestation can mimic acute stroke. Only a few of such cases have been reported in the literature. This report discusses the case of a 46-year-old hypertensive Ghanaian woman who presented to a District Hospital with sudden-onset right-sided flaccid weakness and a high blood pressure. Acute stroke was ruled out with computed tomography scan of the brain. Further laboratory evaluation demonstrated reduced serum potassium level, which was corrected with subsequent dramatic resolution of the muscle weakness.

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“…Atypical weakness, such as asymmetric or focal motor paresis [1,2] mimicking peripheral neuropathy [3] or hemiparesis [4], has been reported on occasion. These atypical presentations, including the patient reported herein, challenge the physician trying to make an accurate diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Periodic Drop Thumb, Hypokalemia and Adrenal Adenoma

2013

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Objective: To report an unusual involvement of focal distal muscles but not proximal muscles in a patient with hypokalemic periodic paralysis (hypoPP). Clinical Presentation and Intervention: A middle-aged woman presented with episodic weakness of the bilateral thumbs lasting for 2 years. Hypokalemia and a left adrenal mass were subsequently found. Her weakness subsided after surgical removal of the adrenal mass, which was pathologically proven to be an adrenal adenoma. Conclusion: The findings for this patient should alert physicians to consider focal distal motor paresis due to hypoPP. A preexisting occult trauma may predispose to paralysis at an atypical location in secondary hypoPP.

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An unusual presentation of hypokalemic paralysis with evolving pure motor hemiparesis

Cited by 9 publications

References 8 publications

The Silent Threat of Hypokalemia after High Voltage Electrical Injuries: A Case Study and Review of the Literature

The Silent Threat of Hypokalemia after High Voltage Electrical Injuries: A Case Study and Review of the Literature

An unusual stroke mimic: A case report

Periodic Drop Thumb, Hypokalemia and Adrenal Adenoma

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