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Hypokalemic Periodic Paralysis

Hypokalemic periodic paralysis (HPP) is an autosomal dominant inherited disorder with imperfect penetration. Attacks are characterized by weakness or paralysis of the limbs and trunk and usually occur after a large carbohydrate meal, with rest after strenuous exercise, or after sleep. A family history is common, but sporadic cases do occur. First attacks occur at a median age of 15 years old, but patients may be as old as 30 years. Attacks may recur frequently.


Hypokalemic periodic paralysis is a condition of intermittent episodes of muscle weakness and sometimes severe paralysis. It is one of a group of genetic disorders that includes hyperkalemic periodic paralysis and thyrotoxic periodic paralysis.

Few of the possible causes of Hypokalemic periodic paralysis are included in the list below:

  • Alcoholism
  • Diet high in sugar
  • Diuretic therapy without potassium chloride
  • Supplementation.
  • Laxative abuse
  • Exact pathogenesis unknown
  • Abnormality is in the muscle membrane
  • Several mutations in either calcium or sodium channel proteins have been identified
  • Contractile apparatus normal


  • Episodic periods of weakness or paralysis affecting the limbs and trunk but sparing the bulbar and diaphragm muscles


  • Limb and trunk weakness
  • Diminished reflexes
  • Sensation and sensorium are intact, but patients have been known to become agitated during attacks.


The goals of treatment are relief of acute symptoms and prevention of further attacks. Potassium that is given during an attack may stop the attack. It is preferred that potassium be given by mouth, but if weakness is severe, intravenous potassium may be necessary. Taking potassium will not prevent attacks. But intravenous potassium should be given with caution, especially in individuals with kidney disease. Some treatment such as includes:

  • A low carbohydrate diet
  • Avoidance of alcohol may be recommended.
  • A low sodium diet may decrease the frequency of attacks.
  • Glucose containing candy

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