Abstract:We present a case of thyrotoxic periodic paralysis (TPP) presenting with stroke symptoms as a harbinger of Grave’s disease. A 61-year-old female presented with symptoms of abdominal pain and fatigue two weeks prior to admission and reported acute diarrhoea and unintentional weight loss. Investigation revealed thyrotoxicosis with undetectable thyroid stimulating hormone (TSH), elevated free T4 and elevated thyroid stimulating immunoglobulin (TSI). On the third day of admission, while undergoing physical therapy… Show more
“…[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. Unlike in our case, the patients in some previous reports had monoparesis.…”
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.
“…[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. Unlike in our case, the patients in some previous reports had monoparesis.…”
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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