Hypokalemic periodic paralysis is a disorder characterized by episodes of weakness, sparing the respiratory muscles, with a matching fall in serum potassium that lasts anywhere from a few hours to a few days.
Hypokalemic periodic paralysis is a “channelopathy” caused by defective sodium, calcium or potassium ion-channels. Episodes of hypokalemia cause weakness by partial depolarization of the muscle cells, without generating action potentials.
In individuals with a mutation, attacks are triggered by strenuous exercise followed by rest, high carbohydrate meals, meals with high sodium content, sudden changes in temperature, and, in some cases, even excitement, noise, flashing lights and induced by cold temperatures.
To manage patients intraoperatively, monitor potassium levels and avoid glucose solutions or solutions with a high sodium content.
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