THYROTOXIC PERIODIC PARALYSIS

In an Oriental patient with thyrotoxic periodic paralysis, six weeks of therapy with reserpine alone returned the pulse rate to normal and reduced nervousness but did not prevent the attacks of periodic paralysis. These observations imply that hyperactivity of the sympathetic nervous system is not an essential feature of the mechanism by which hyperthyroidism predisposes certain patients to hypokalemic periodic paralysis. Prior to antithyroid treatment, aldosterone secretion and metabolic clearance rates were prominently elevated; after propylthiouracil therapy, both returned to normal. An intravenous glucose and insulin provocation test prior to antithyroid therapy produced striking hypokalemia and paralysis, but after antithyroid treatment an identical challenge failed to do so. The periodic paralysis disappeared on therapy with propylthiouracil and baseline muscle strength rose remarkably. © 1969.