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Types of periodic paralysis

by — Last updated: 2020-08-14 in Nervous System Disorders and Diseases
Reviewed by Medical Team — 2017-09-25

Table of Contents

Paralysis is a complete loss of muscle function in one or more muscle groups in the body. Temporary paralysis lasts a short amount of time — anywhere from a few minutes to up to a few months.

Periodic paralysis is an inherited myopathy with significant variation in symptomatology, leading to a spectrum of familial phenotypes. Specific diseases include [12] the following.

Hypokalemic Periodic Paralysis

Hypokalemic periodic paralysis is characterized by a fall in potassium levels in the blood. This particular weakness may be mild and limited to certain muscle groups, or more severe and can affect the arms and legs. Attacks may last for a few hours or persist for several days.

Hyperkalemic Periodic Paralysis

Hyperkalemic periodic paralysis is an inherited disorder which affects sodium channels in muscle cells and the ability to regulate potassium levels. This inherited condition is characterized by uncontrollable muscle twitching and muscle weakness or paralysis.

Paramyotonia Congenita  

Paramyotonia congenita is a rare congenital disorder which is characterized by a condition in which the muscles do not relax after contracting. The problem is caused by the nerves, not the muscles.

Andersen-Tawil Syndrome

Andersen-Tawil syndrome is a rare genetic disorder which affects the heart. Symptoms are a disruption in the rhythm of the heart's lower chambers in addition to the symptoms of long QT syndrome. These changes disrupt the flow of potassium ions in skeletal and cardiac muscle, leading to the periodic paralysis and irregular heart rhythm. [13]

Diagnosing paralysis

While the cause of paralysis may be easily diagnosed in stroke victims, the genetic group of diseases that cause paralysis is unusually difficult to diagnose. In most cases, patients report many wrong diagnoses and treatments that made them worse. The following diagnostic tests may lead to a correct diagnosis.

  • DNA-testing. A DNA testing is available for only a half dozen common gene mutations, while dozens of known mutations are possible, but are not routinely tested.
  • Exercise EMG test. A properly performed Compound Muscle Amplitude Potential Test can provide an accurate diagnosis in more than 80% of cases. 

Treatment for paralysis

Treatment of the periodic paralysis usually includes:

  • Carbonic anhydrase inhibitors (such as Acetazolamide or Dichlorphenamide)
  • Supplemental oral potassium chloride-for hypo-cases or avoiding potassium for hyper-cases
  • Thiazide diuretics to manipulate the amount of potassium retained by the kidneys
  • Significant lifestyle changes including tightly controlled levels of exercise or activity

Although the treatment of choice in periodic paralysis is generally considered to be acetazolamide, there is no standardized treatment regimen as to when to start treatment. Scientists still do not know if acetazolamide treatment prevents any permanent weakness that may occur due to periodic paralysis. [14]

Prognosis

Prognosis of periodic paralysis can vary because the disability caused by paralysis can range from a minor weakness to permanent muscle damage, an inability to hold a job, and the need to use a power chair. Fortunately, most people function fairly well with medicines and lifestyle changes.