IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-9-2-24144 Original Research Paper A Case of Thyrotoxic Periodic Paralysis An Underdiagnosed & Underrecognised condition. DEEPTHI KANUGANTI Dr. February 2020 9 2 01 02 ABSTRACT

Thyrotoxic periodic paralysis (TPP) is a rare condition characterized by a triad of symptoms which include acute hypokalemia without total body potassium deficit, episodic muscle paralysis and uncontrolled hyperthyroidism. A 27yr old gentleman presented with complaints of loose stools, palpitations and weakness of all 4 limbs (predominantly lower limbs). Hypokalemia was documented in the patient. Prominent eyes and few signs of wide pulse pressure like water–hammer pulse, locomotor brachii and dancing carotids were also noticed. The above observations at first lead us to believe that the patient may have Hypokalemic Periodic Paralysis with Aortic Regurgitation. After the correction of hypokalemia, weakness regressed to a minimum but exophthalmos and signs of wide pulse pressure were still prevailed in the patient. After re–examining the clinical vignette and doing a thyroid profile & ultrasound of neck on the patient, we finally came to a conclusion and diagnosed the patient as having TPP associated with Hashitoxicosis. Subsequently the patient was treated with propronolol and carbimazole. TPP can often be the first manifestation of thyrotoxicosis as in our case but it is a very rare disorder to encounter in India when compared to western countries. So one should suspect this condition in patients with weakness & hypokalemia because it is a curable cause of hypokalemic periodic paralysis.