{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T08:38:07Z","timestamp":1759826287658,"version":"3.40.4"},"reference-count":5,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"published-print":{"date-parts":[[2009]]},"abstract":"<jats:p>A 22-year-old Chinese man presented with sudden onset of generalised muscular weakness and paralysis upon awakening in the morning, due to sporadic periodic paralysis (SPP), a type of hypokalaemic periodic paralysis (HPP) without hyperthyroidism or familial history of paralysis. Laboratory studies showed marked hypokalaemia (K<jats:sup>+<\/jats:sup>1.6 mmol\/litre). He received intravenous KCl supplementation at a rate of 0.14 mmol\/kg\/h and developed a paradoxical fall in serum K<jats:sup>+<\/jats:sup>concentration from 1.6 to 1.4 mmol\/litre during KCl therapy. After 160 mmol KCl supplementation his muscular strength recovered, but muscular paralysis recurred 2 h later. Acute recurrent hypokalaemia was the presumptive initial diagnosis and intravenous KCl supplementation was briefly reinitiated. Despite no obvious abnormalities on ECG monitoring, a 12-lead ECG clearly demonstrated tented T waves in the precordial leads suggestive of hyperkalaemia, later found to be 6.9 mmol\/litre. After treatment with intravenous calcium gluconate, insulin and loop diuretics, his serum K<jats:sup>+<\/jats:sup>concentration fell to 4.7 mmol\/litre and muscular paralysis resolved in 3 h.<\/jats:p>","DOI":"10.1136\/bcr.07.2008.0577","type":"journal-article","created":{"date-parts":[[2009,3,17]],"date-time":"2009-03-17T19:41:52Z","timestamp":1237318912000},"page":"bcr0720080577","source":"Crossref","is-referenced-by-count":8,"title":["Recurring paralysis"],"prefix":"10.1136","volume":"2009","author":[{"given":"Hung-Wei","family":"Lin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Chau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chin-Sheng","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih-Hua","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2009,3,17]]},"reference":[{"key":"2025042507364837000_2009.mar08_1.bcr0720080577.1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/94.3.133"},{"key":"2025042507364837000_2009.mar08_1.bcr0720080577.2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.14.1561"},{"key":"2025042507364837000_2009.mar08_1.bcr0720080577.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)79515-5"},{"key":"2025042507364837000_2009.mar08_1.bcr0720080577.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2003.05.004"},{"key":"2025042507364837000_2009.mar08_1.bcr0720080577.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.324.7349.1320"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr.07.2008.0577","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T14:36:51Z","timestamp":1745591811000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr.07.2008.0577"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009]]},"references-count":5,"alternative-id":["10.1136\/bcr.07.2008.0577"],"URL":"https:\/\/doi.org\/10.1136\/bcr.07.2008.0577","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2009]]}}}