Hypokalemic Paraplegia in Pregnancy

M, Kulkarni; Tv, Srividya; Gopal, Nanda

doi:10.7860/jcdr/2014/8793.4433

Cited by 7 publications

(10 citation statements)

References 13 publications

(7 reference statements)

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“…The cases we identified of hypokalemic periodic paralysis in pregnancy utilized epidural analgesia during labor to minimize maternal stress and hyperventilation, which could trigger a decrease in serum potassium . Our patient received early administration of a combined spinal‐epidural for similar reasons.…”

Section: Discussionmentioning

confidence: 95%

“…Betamethasone can also trigger hypokalemic paralytic episodes, warranting caution and close monitoring of maternal potassium levels when used. Similarly, beta‐sympathomimetics such as terbutaline should be avoided . Epinephrine is well‐tolerated by some patients with f‐hypoPP, while triggering attacks in others …”

Section: Discussionmentioning

confidence: 99%

“…A common way of reducing maternal exhaustion during the second stage of labor is passive descent with operative vaginal delivery . Forceps‐assisted delivery was planned for our patient if maternal exhaustion, weakness, paralysis or hypokalemia developed.…”

Section: Discussionmentioning

confidence: 99%

“…A PubMed search using the keywords ‘hypokalemic paralysis AND pregnancy’ revealed a handful of pertinent cases. In multiple reports, hypokalemic periodic paralysis is diagnosed during the pregnancy, resulting in limited guidance on how to optimize obstetric care for women with a known diagnosis . Three cases describe women with f‐hypoPP diagnosed before the documented pregnancy; one is not available in English, one considers f‐hypoPP in the presence of Wolff‐Parkinson‐White syndrome and the third focuses on anesthetic management .…”

Section: Introductionmentioning

confidence: 99%

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Familial hypokalemic periodic paralysis in pregnancy: A case report

Frappaolo¹,

Vadnais²

2019

J of Obstet and Gynaecol

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Familial hypokalemic periodic paralysis (f-hypoPP) is a rare neuromuscular disorder causing intermittent muscle paralysis. Pregnancy can exacerbate f-hypoPP, yet obstetric management is not well documented. We present a case of a nulliparous woman with f-hypoPP, outlining a complete prenatal care plan generalizable to other women with known f-hypoPP. To our knowledge, this is the first obstetric f-hypoPP case to prioritize intrapartum oral potassium over intravenous potassium, as well as to outline the importance of multidisciplinary care. The patient had a spontaneous vaginal delivery at term with an uneventful postpartum period. Muscle weakness and episodes of relative hypokalemia in the second trimester and during labor were effectively treated with oral potassium supplementation. Care was provided by a multidisciplinary team, and caution was taken to avoid known triggers of paralytic episodes.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Familial hypokalemic periodic paralysis in pregnancy: A case report

Frappaolo¹,

Vadnais²

2019

J of Obstet and Gynaecol

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“…Oleh karena itu, hipokalemia pada pasien adalah suatu HPP primer (idiopatik atau familial). 10,11,17 HPP bukan merupakan penyakit yang berhubungan dengan kehamilan sehingga HPP tidak menjadi indikasi terminasi kehamilan. Pemberian steroid dapat mencetuskan HPP.…”

Section: Diskusiunclassified

Tata laksana Pasien Gravida 29–30 Minggu dengan Gagal Napas ec. Hypokalemic Periodic Paralysis yang Diperberat dengan Community Acquired Pneumonia

Gunadi

Suwarman²,

S³

2019

jap

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Penatalaksanaan sakit kritis pada wanita hamil memiliki karakteristik yang unik karena perubahan fisiologi selama kehamilan dan janin yang berkembang dalam uterus yang mendapat implikasi yang signifikan. Pada kasus ini, seorang perempuan 27 tahun yang sedang hamil gemeli usia kehamilan 29–30 minggu datang ke Instalasi Gawat Darurat (IGD) Rumah Sakit Dr. Hasan Sadikin Bandung dengan keluhan utama kelemahan keempat anggota gerak. Hasil pemeriksaan laboratorium didapatkan kadar kalium sangat rendah dan didiagnosis dengan hypokalemic periodic paralysis. Pasien mengalami gagal napas sehingga dilakukan intubasi dan diberikan bantuan ventilasi mekanik, kemudian dirawat di Intensive Care Unit (ICU). Gagal napas disertai penyulit community acquired pneumonia. Tata laksana ventilasi mekanik pada wanita hamil di ICU bersifat suportif dengan teknik sama seperti pada pasien tidak hamil, namun memiliki target khusus yang berbeda. Monitoring fetal heart rate (FHR) dapat mencerminkan kesejahteraan janin dan kondisi ibu. Tujuan penulisan laporan kasus ini adalah mengetahui pentingnya target pemberian ventilasi mekanik dan melakukan monitoring FHR pada pasien hamil di ICU. Management of Respiratory Failure Due to Hypokalemic Periodic Paralysis Complicated with Community Acquired Pneumonia in 29–30 Weeks of GestationManagement of critically ill pregnant women in Intensive Care Unit (ICU) has unique characteristics due to the physiological changes during pregnancy and the presence of growing fetus in the uterine which may present significant implications. This study presented a case of a 27 years old woman with 29–30 weeks of gestation of twin pregnancy who came to Emergency Room (ER) with the chief complaint of weakness in both lower and upper extremities. Laboratory investigations showed a very low potassium level and the patient was diagnosed with hypokalemic periodic paralysis. Patient then experienced respiratory failure at the ER, intubated, and mechanically ventilated and was sent to the ICU. Community-acquired pneumonia was complicating the respiratory failure. Basically, mechanical ventilation management for pregnant patient in ICU is supportive in nature and uses the same techniques employed for the non-pregnant patient. However, the goals are different as it is important to monitor fetal heart rate (FHR) in pregnant woman as this does not only reflect the fetal well-being but also the maternal condition. This case report is intended to show the importance of mechanical ventilation goal and FHR monitoring in pregnant patients in ICU.

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Treatment of muscle weakness in neuromuscular disorders

Finsterer

Zarrouk‐Mahjoub

2016

Expert Review of Neurotherapeutics

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Weakness is one of the predominant clinical manifestations of neuromuscular disorders (NMDs), which strongly influences daily life, prognosis, and outcome of affected patients. One of the major therapeutic goals in NMD-patients is to completely resolve muscle weakness. Various treatment options are available and include physical therapy, electrotherapy, diet, drugs, avoidance or withdrawal of muscle-toxic and weakness-inducing agents, detoxification, stem-cell-therapy, plasma-exchange, respiratory therapy, or surgery. Most accessible to treatment is weakness from immune-mediated neuropathies, immune-mediated transmission-disorders, and idiopathic immune myopathies. Areas covered: This manuscript aims to summarize and discuss recent findings and future perspectives concerning the treatment of muscle weakness in NMDs. Data were obtained by a literature search in databases such as PubMed and Current-Contents. Expert commentary: Weakness is most easily treatable in acquired NMDs and in hereditary myopathies and neuropathies beneficial treatment options are also available. Research needs to be encouraged and intensified to further expand the spectrum of treatment options for weakness.

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Hypokalemic Paraplegia in Pregnancy

Cited by 7 publications

References 13 publications

Familial hypokalemic periodic paralysis in pregnancy: A case report

Familial hypokalemic periodic paralysis in pregnancy: A case report

Tata laksana Pasien Gravida 29–30 Minggu dengan Gagal Napas ec. Hypokalemic Periodic Paralysis yang Diperberat dengan Community Acquired Pneumonia

Treatment of muscle weakness in neuromuscular disorders

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