{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T20:27:58Z","timestamp":1776544078537,"version":"3.51.2"},"reference-count":60,"publisher":"Oxford University Press (OUP)","issue":"882","license":[{"start":{"date-parts":[[1999,4,1]],"date-time":"1999-04-01T00:00:00Z","timestamp":922924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1999,4,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>Hypokalaemic paralysis is a relatively uncommon but potentially life-threatening clinical syndrome. If recognised and treated appropriately, patients recover without any clinical sequellae. The syndrome of hypokalaemic paralysis represents a heterogenous group of disorders characterised clinically by hypokalaemia and acute systemic weakness. Most cases are due to familial or primary hypokalaemic periodic paralysis; sporadic cases are associated with numerous other conditions including barium poisoning, hyperthyroidism, renal disorders, certain endocrinopathies and gastrointestinal potassium losses. The age of onset, race, family history, medications, and underlying disease states can help in identifying the cause of hypokalaemic paralysis. Initial therapy of the patient with hypokalaemic paralysis includes potassium replacement and search for underlying aetiology. Further management depends on the aetiology of hypokalaemia, severity of symptoms, and duration of disease. This review presents the differential diagnosis for hypokalaemic paralysis and discusses management of the syndrome.<\/jats:p>","DOI":"10.1136\/pgmj.75.882.193","type":"journal-article","created":{"date-parts":[[2015,2,18]],"date-time":"2015-02-18T00:04:10Z","timestamp":1424217850000},"page":"193-197","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":112,"title":["Hypokalaemic paralysis"],"prefix":"10.1093","volume":"75","author":[{"given":"Sushil K","family":"Ahlawat","sequence":"first","affiliation":[{"name":"Department of Medicine, OLM Medical Center\/New York Medical College , New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anita","family":"Sachdev","sequence":"additional","affiliation":[{"name":"Department of Medicine, Elmhurst Hospital Center\/Mount Sinai School of Medicine , New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1999,4,1]]},"reference":[{"key":"2023042616222845100_B1","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1038\/ng0394-267","article-title":"Mapping of the hypokalemic periodic paralysis (Hypo PP) locus to chromosome 1q31\u201332 in three European families","volume":"6","author":"Fontaine","year":"1994","journal-title":"Nat Genet"},{"key":"2023042616222845100_B2","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1002\/mus.880070205","article-title":"Hypokalemic periodic paralysis: in vitro investigation of muscle fiber parameters","volume":"7","author":"Rudel","year":"1984","journal-title":"Muscle Nerve"},{"key":"2023042616222845100_B3","doi-asserted-by":"crossref","first-page":"1522","DOI":"10.1212\/WNL.33.11.1522","article-title":"Interictal conduction slowing in muscle fibers in hypokalemic periodic paralysis","volume":"33","author":"Troni","year":"1983","journal-title":"Neurology"},{"key":"2023042616222845100_B4","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/0960-8966(91)90095-A","article-title":"Different gene locii for hyperkalemic and hypokalemic periodic paralysis","volume":"1","author":"Fontaine","year":"1991","journal-title":"Neuromusc Disord"},{"key":"2023042616222845100_B5","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1001\/archinte.1990.00390150101019","article-title":"Rapid correction of hypokalemia using concentrated intravenous potassium chloride infusions","volume":"150","author":"Kruse","year":"1990","journal-title":"Arch Intern Med"},{"key":"2023042616222845100_B6","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1001\/archneur.1983.04050080039005","article-title":"Intravenous treatment of hypokalemic periodic paralysis","volume":"40","author":"Griggs","year":"1983","journal-title":"Arch Neurol"},{"key":"2023042616222845100_B7","doi-asserted-by":"crossref","first-page":"39","DOI":"10.7326\/0003-4819-73-1-39","article-title":"Acetazolamide treatment of hypokalemic periodic paralysis","volume":"73","author":"Griggs","year":"1970","journal-title":"Ann Intern Med"},{"key":"2023042616222845100_B8","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1136\/bmj.1.5538.451","article-title":"Periodic paralysis complicating thyrotoxicosis in Chinese","volume":"1","author":"McFadzean","year":"1967","journal-title":"BMJ"},{"key":"2023042616222845100_B9","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/0002-9343(61)90104-8","article-title":"Thyroid function and periodic paralysis","volume":"30","author":"Engel","year":"1961","journal-title":"Am J Med"},{"key":"2023042616222845100_B10","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/S0196-0644(88)80568-7","article-title":"Thyrotoxic periodic paralysis","volume":"17","author":"Bergeron","year":"1988","journal-title":"Ann Emerg Med"},{"key":"2023042616222845100_B11","doi-asserted-by":"crossref","first-page":"241","DOI":"10.7326\/0003-4819-43-2-241","article-title":"Periodic paralysis associated with hyperthyroidism: report of three cases","volume":"43","author":"Lider","year":"1955","journal-title":"Ann Intern Med"},{"key":"2023042616222845100_B12","doi-asserted-by":"crossref","first-page":"332","DOI":"10.7326\/0003-4819-81-3-332","article-title":"Thyrotoxicosis and periodic paralysis: improvement with beta blockade","volume":"81","author":"Conway","year":"1974","journal-title":"Ann Intern Med"},{"key":"2023042616222845100_B13","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1089\/thy.1994.4.441","article-title":"Thyrotoxic hypokalemic periodic paralysis: report of four cases in black American males","volume":"4","author":"Kilpatrick","year":"1994","journal-title":"Thyroid"},{"key":"2023042616222845100_B14","first-page":"1172","article-title":"Hypokalemic paralysis in remote aboriginal communities","volume":"25","author":"Ghose","year":"1996","journal-title":"Aust Fam Physician"},{"key":"2023042616222845100_B15","doi-asserted-by":"crossref","first-page":"2597","DOI":"10.1001\/archinte.1989.00390110139031","article-title":"Thyrotoxic periodic paralysis. Report of 10 cases and review of electromyographic findings","volume":"149","author":"Kelley","year":"1989","journal-title":"Arch Intern Med"},{"key":"2023042616222845100_B16","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1001\/archneur.1972.00490120083009","article-title":"Thyrotoxic periodic paralysis: periodic variation in the muscle calcium pump activity","volume":"26","author":"Au","year":"1972","journal-title":"Arch Neurol"},{"key":"2023042616222845100_B17","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1016\/0002-9343(74)90010-2","article-title":"Thyrotoxic periodic paralysis. Effect of propranolol","volume":"57","author":"Yeung","year":"1974","journal-title":"Am J Med"},{"key":"2023042616222845100_B18","first-page":"296","article-title":"Pa Ping or Kiating paralysis","volume":"61","author":"Allen","year":"1943","journal-title":"Chin Med J (Engl)"},{"key":"2023042616222845100_B19","first-page":"495","volume-title":"Clinical toxicology","author":"Polson","year":"1984","edition":"3rd"},{"key":"2023042616222845100_B20","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1016\/S0140-6736(64)90281-8","article-title":"Food poisoning from barium carbonate","volume":"ii","author":"Lewi","year":"1964","journal-title":"Lancet"},{"key":"2023042616222845100_B21","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1001\/archneur.1988.00520290119024","article-title":"Acute paralysis from inhaled barium carbonate","volume":"45","author":"Shankle","year":"1988","journal-title":"Arch Neurol"},{"key":"2023042616222845100_B22","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1002\/ana.410110602","article-title":"Periodic paralysis and sodium-potassium pump","volume":"11","author":"Layzer","year":"1982","journal-title":"Ann Neurol"},{"key":"2023042616222845100_B23","first-page":"110","article-title":"Hypokalemia of barium poisoning","volume":"1","author":"Berning","year":"1978","journal-title":"Lancet"},{"key":"2023042616222845100_B24","first-page":"148","article-title":"Barium","volume":"107","author":"WHO Working Group","year":"1990","journal-title":"Environ Hlth Criteria"},{"key":"2023042616222845100_B25","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1146\/annurev.pa.16.040176.001201","article-title":"Current concepts about the treatment of selected poisoning. Nitrite, cyanide, sulfide, barium, and quinidine","volume":"16","author":"Smith","year":"1976","journal-title":"Ann Rev Pharmacol Toxicol"},{"key":"2023042616222845100_B26","doi-asserted-by":"crossref","first-page":"187","DOI":"10.7326\/0003-4819-95-2-187","article-title":"Acute renal failure associated with barium chloride poisoning","volume":"95","author":"Wertherill","year":"1981","journal-title":"Ann Intern Med"},{"key":"2023042616222845100_B27","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1136\/bmj.289.6449.882","article-title":"Is hypokalemia the cause of paralysis in barium poisoning?","volume":"289","author":"Phelan","year":"1984","journal-title":"BMJ"},{"key":"2023042616222845100_B28","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1177\/004947559502500304","article-title":"Hypokalemic paralysis secondary to acute barium carbonate toxicity","volume":"25","author":"Agarwal","year":"1995","journal-title":"Trop Doctor"},{"key":"2023042616222845100_B29","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1136\/pgmj.60.702.303","article-title":"Medullary sponge kidney presenting with hypokalemic paralysis","volume":"60","author":"Jayasinghe","year":"1984","journal-title":"Postgrad Med J"},{"key":"2023042616222845100_B30","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1001\/archinte.1981.00340130109026","article-title":"Hypokalemic periodic paralysis in Sjogren's syndrome","volume":"141","author":"Raskin","year":"1981","journal-title":"Arch Intern Med"},{"key":"2023042616222845100_B31","doi-asserted-by":"crossref","first-page":"405","DOI":"10.7326\/0003-4819-110-5-405","article-title":"Hypokalemic periodic paralysis due to Sjogren's syndrome in Chinese patients","volume":"110","author":"Pun","year":"1989","journal-title":"Ann Intern Med"},{"key":"2023042616222845100_B32","doi-asserted-by":"crossref","first-page":"1735","DOI":"10.1002\/art.1780361213","article-title":"Sjogren's syndrome presenting as hypokalemic periodic paralysis","volume":"36","author":"Dowd","year":"1993","journal-title":"Arthritis Rheum"},{"key":"2023042616222845100_B33","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1001\/archneur.1980.00500590097021","article-title":"Hypokalemic periodic paralysis in chronic toluene exposure","volume":"37","author":"Bennett","year":"1980","journal-title":"Arch Neurol"},{"key":"2023042616222845100_B34","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1056\/NEJM197404042901403","article-title":"Renal tubular acidosis associated with toluene \u2018sniffing\u2019","volume":"290","author":"Taher","year":"1974","journal-title":"N Engl J Med"},{"key":"2023042616222845100_B35","first-page":"61","article-title":"Observations on the Fanconi syndrome and renal hyperchloremic acidosis in the adult","volume":"21","author":"Milne","year":"1951","journal-title":"Q J Med"},{"key":"2023042616222845100_B36","first-page":"791","article-title":"Cystinosis (Lignac-Fanconi disease)","volume":"31","author":"Schultz","year":"1955","journal-title":"Am J Pathol"},{"key":"2023042616222845100_B37","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1097\/00003246-198711000-00017","article-title":"Hypokalemic paralysis associated with renal tubular acidosis","volume":"15","author":"Rowbottom","year":"1987","journal-title":"Crit Care Med"},{"key":"2023042616222845100_B38","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1172\/JCI106537","article-title":"Renal potassium wasting in renal tubular acidosis (RTA). Its occurrence in types 1 and 2 RTA despite sustained correction of systemic acidosis","volume":"50","author":"Sebastian","year":"1971","journal-title":"J Clin Invest"},{"key":"2023042616222845100_B39","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1159\/000187402","article-title":"Salt wastage, plasma volume contraction and hypokalemic paralysis in self induced water intoxication","volume":"64","author":"Tanneau","year":"1993","journal-title":"Nephron"},{"key":"2023042616222845100_B40","first-page":"7","article-title":"Defects of renal tubular function in the nephrotic syndrome","volume":"25","author":"Standbury","year":"1957","journal-title":"Q J Med"},{"key":"2023042616222845100_B41","first-page":"379","article-title":"Renal function studies in acute tubular necrosis","volume":"9","author":"Bull","year":"1950","journal-title":"Clin Sci"},{"key":"2023042616222845100_B42","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/S0272-6386(12)81064-X","article-title":"Acute muscular paralysis in an adult with subclinical Barter's syndrome associated with gentamicin administration","volume":"24","author":"Shiah","year":"1994","journal-title":"Am J Kidney Dis"},{"key":"2023042616222845100_B43","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.7326\/0003-4819-30-6-1272","article-title":"Paralysis due to reduced potassium during treatment of diabetic acidosis","volume":"30","author":"Stephens","year":"1949","journal-title":"Ann Intern Med"},{"key":"2023042616222845100_B44","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/S0140-6736(52)90638-7","article-title":"Treatment of diabetic ketosis","volume":"1","author":"Nabarro","year":"1952","journal-title":"Lancet"},{"key":"2023042616222845100_B45","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1001\/jama.1959.63010170003010a","article-title":"Hypokalemic muscle paralysis associated with administration of chlorthiazide","volume":"170","author":"Cohen","year":"1959","journal-title":"JAMA"},{"key":"2023042616222845100_B46","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/S0022-5347(17)65379-5","article-title":"Potassium paresis following ureterosigmoidostomy","volume":"85","author":"Sataline","year":"1961","journal-title":"J Urol"},{"key":"2023042616222845100_B47","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1111\/j.1464-410X.1959.tb09418.x","article-title":"Hypokalemic paresis after bilateral ureterosigmoidostomy and treatment of a case","volume":"31","author":"Steinbeck","year":"1959","journal-title":"Br J Urol"},{"key":"2023042616222845100_B48","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/0002-9610(64)90252-1","article-title":"Clinical characteristics of primary aldosteronism from an analysis of 145 cases","volume":"107","author":"Conn","year":"1974","journal-title":"Am J Surg"},{"key":"2023042616222845100_B49","first-page":"1021","article-title":"Fifty cases of primary hyperaldosteronism in Hong Kong Chinese with a high frequency of periodic paralysis. Evaluation of techniques of tumor localization","volume":"61","author":"Ma","year":"1986","journal-title":"Q J Med"},{"key":"2023042616222845100_B50","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1016\/S0140-6736(84)92495-4","article-title":"Life-threatening hypokalemia caused by liquorice ingestion","volume":"1","author":"Nielsen","year":"1984","journal-title":"Lancet"},{"key":"2023042616222845100_B51","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1056\/NEJM196603172741104","article-title":"Hypokalemic myopathy with myoglobinuria associated with licorice ingestion","volume":"274","author":"Gross","year":"1966","journal-title":"N Engl J Med"},{"key":"2023042616222845100_B52","doi-asserted-by":"crossref","first-page":"488","DOI":"10.1136\/bmj.1.6059.488","article-title":"Effect of eating liquorice on the renin-angiotensin aldosterone axis in normal subjects","volume":"1","author":"Epstein","year":"1977","journal-title":"BMJ"},{"key":"2023042616222845100_B53","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1136\/pgmj.56.657.526","article-title":"Severe hypokalemia with paralysis induced by small doses of liquorice","volume":"56","author":"Cumming","year":"1980","journal-title":"Postgrad Med J"},{"key":"2023042616222845100_B54","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1136\/bmj.2.5658.674","article-title":"Muscle paresis and hypokalemia after treatment with Duogastrone","volume":"2","author":"Forshaw","year":"1969","journal-title":"BMJ"},{"key":"2023042616222845100_B55","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1136\/bmj.1.5503.1581","article-title":"Hypokalemia, flaccid quadriparesis and myoglobinuria with carbenoxolone (biogastrone)","volume":"1","author":"Mohammed","year":"1966","journal-title":"BMJ"},{"key":"2023042616222845100_B56","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1001\/archpedi.1968.02100020418013","article-title":"Potassium depletion paralysis associated with gluten-induced enteropathy","volume":"116","author":"Musselman","year":"1968","journal-title":"Am J Dis Child"},{"key":"2023042616222845100_B57","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1111\/j.1600-0404.1994.tb02740.x","article-title":"Hypokalemic periodic paralysis in association with tropical sprue: a case report","volume":"90","author":"Ghosh","year":"1994","journal-title":"Acta Neurol Scand"},{"key":"2023042616222845100_B58","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1001\/archinte.1989.00390050145030","article-title":"Flaccid quadriparesis associated with Yersinia enterocolitis-induced hypokalemia","volume":"149","author":"Orman","year":"1989","journal-title":"Arch Intern Med"},{"key":"2023042616222845100_B59","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1097\/00003246-198608000-00020","article-title":"Quadriparesis due to potassium depletion","volume":"14","author":"Manary","year":"1986","journal-title":"Crit Care Med"},{"key":"2023042616222845100_B60","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1093\/rheumatology\/35.3.289","article-title":"Thyrotoxicosis and renal tubular acidosis presenting as hypokalemic paralysis","volume":"35","author":"Szeto","year":"1996","journal-title":"Br J Rheumatol"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/75\/882\/193\/50046755\/postgradmedj-75-193.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/75\/882\/193\/50046755\/postgradmedj-75-193.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T16:27:48Z","timestamp":1682526468000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/75\/882\/193\/7045033"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,4,1]]},"references-count":60,"journal-issue":{"issue":"882","published-online":{"date-parts":[[1999,4,1]]},"published-print":{"date-parts":[[1999,4,1]]}},"URL":"https:\/\/doi.org\/10.1136\/pgmj.75.882.193","relation":{},"ISSN":["0032-5473","1469-0756"],"issn-type":[{"value":"0032-5473","type":"print"},{"value":"1469-0756","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1999,4]]},"published":{"date-parts":[[1999,4,1]]}}}