scholarly journals Parésia Hipocaliemica em Adolescente: Um Caso Clínico

2019 ◽  
Vol 32 (5) ◽  
pp. 400
Author(s):  
Ana Catarina Carvalho ◽  
Joana Matos ◽  
Susana Lira ◽  
Ana Reis
Keyword(s):  
Autosomal Dominant ◽  
Acute Flaccid Paralysis ◽  
Pediatric Emergency ◽  
Sudden Onset ◽  
Periodic Paralysis ◽  
Flaccid Paralysis ◽  
Rare Form ◽  
Fourth Decade ◽  
History Of ◽  
Hypokalaemic Periodic Paralysis

Familial hypokalaemic periodic paralysis is a rare autosomal dominant neuromuscular disease characterized by episodic attacks of flaccid paralysis with concomitant hypokalaemia. We present a case of a 15-year-old male adolescent observed in the pediatric emergency department by flaccid paresis of the 4 limbs of sudden onset and progressive worsening. In the anamnesis, corticosteroid and antihistamine intake were observed on the previous day for urticaria and family history of transient episodes of flaccid paralysis in adolescence, asymptomatic after the fourth decade of life, without an established diagnosis. Diagnostic tests revealed hypokalaemia (K + < 2.4 mEq/L), without hypokaluria and without other changes. Symptomatology resolution after supplementation with potassium was verified until normalization of kaliemia. Flaccid paralysis is a rare form of presentation of hypokalaemia. Several etiologies may be involved in the child or adolescent presenting with acute flaccid paralysis. The description of this case draws attention to the importance of the knowledge of this entity, because if recognized and treated properly, patients usually recover without sequelae.

Hypokalaemia periodic paralysis

2017 ◽  
Vol 63 (1) ◽  
pp. 28-31 ◽  
Author(s):  
Liam J Stapleton
Keyword(s):  
Skeletal Muscle ◽  
Serum Potassium ◽  
Young Patients ◽  
Sudden Onset ◽  
Periodic Paralysis ◽  
Flaccid Paralysis ◽  
Blood Tests ◽  
Undetectable Serum ◽  
Potassium Replacement ◽  
Hypokalaemic Periodic Paralysis

Hypokalaemic periodic paralysis is a rare skeletal muscle channelopathy causing flaccid paralysis, which predominantly presents in adolescents and young adults. I report a case of a 33-year-old Caucasian man who presented with sudden onset paralysis, following previous similar presentations without investigation. Blood tests revealed undetectable serum potassium levels in the context of paralysis. Other causes of hypokalaemia were excluded, and the patient was treated with planned lifelong prophylactic potassium replacement for a diagnosis of primary hypokalaemic periodic paralysis. This case demonstrates that, although rare, hypokalaemic periodic paralysis should be considered as a differential diagnosis in young patients who present with sudden flaccid paralysis and can easily be excluded by checking serum potassium levels at presentation.

scholarly journals Spinocerebellar ataxia type 10 in the South of Brazil: the Amerindian-Belgian connection

2015 ◽  
Vol 73 (8) ◽  
pp. 725-727 ◽  
Author(s):  
Hélio Afonso Ghizoni Teive ◽  
Adriana Moro ◽  
Mariana Moscovich ◽  
Walter Oleskho Arruda ◽  
Renato Puppi Munhoz ◽  
...  
Keyword(s):  
Latin America ◽  
Spinocerebellar Ataxia ◽  
Autosomal Dominant ◽  
Spinocerebellar Ataxia Type ◽  
The South ◽  
Rare Form ◽  
History Of ◽  
Autosomal Dominant Ataxia ◽  
South Of Brazil ◽  
Dominant Ataxia

Spinocerebellar ataxia type 10 (SCA10) is a rare form of autosomal dominant ataxia found predominantly in patients from Latin America with Amerindian ancestry. The authors report the history of SCA10 families from the south of Brazil (the states of Paraná and Santa Catarina), emphasizing the Belgian-Amerindian connection.

scholarly journals Hypokalemic periodic paralysis: a case report

2019 ◽  
Vol 1 (Number 2) ◽  
pp. 29-31
Author(s):  
Golam Nabi ◽  
Fahmida Ferdou ◽  
Sadika Kadir ◽  
Sarah Ambarin Chowdhury ◽  
Mohammad Babul Miah ◽  
...  
Keyword(s):  
Autosomal Dominant ◽  
Genetic Disorder ◽  
Sudden Onset ◽  
Periodic Paralysis ◽  
Laboratory Evaluation ◽  
Hypokalemic Periodic Paralysis ◽  
Skeletal Muscle Weakness ◽  
Low Potassium ◽  
Carbohydrate Load ◽  
Rare Group

Hypokalemic periodic paralysis (HKPP) is a rare genetic disorder with autosomal dominant inheritance and characterized by recurrent attacks of skeletal muscle weakness with associated hypokalemia which is precipitated by stress, cold, carbohydrate load, infection, glucose infusion, hypothermia, metabolic alkalosis, anesthesia and steroids. Hypokalemic Periodic Paralysis is one form of Periodic Paralysis, a rare group of disorders that can cause of sudden onset weakness. A case of a 29 year old male is presented here. The patient presented with sudden onset paralysis of his extremities. Laboratory evaluation revealed a markedly low potassium level. The patient’s paralysis resolved upon repletion of his low potassium and he was discharged with no neurologic deficits. Although rare, Periodic Paralysis must differentiated from other causes of weakness and paralysis so that the proper treatment can be initiated quickly.

scholarly journals Snake Eye Appearance; A Rare Radiology Presentation in Acute Flaccid Paralysis: A Case Report

2021 ◽  
Vol 15 (1) ◽  
pp. 43-47
Author(s):  
Mohammad Vafaee-Shahi ◽  
Roghayeh Saeedi ◽  
Neda Pak ◽  
Aina Riahi ◽  
Saeide Ghasemi
Keyword(s):  
Spinal Cord ◽  
Differential Diagnosis ◽  
Brain Stem ◽  
Acute Flaccid Paralysis ◽  
Muscle Tone ◽  
Brain Mri ◽  
Sudden Onset ◽  
Flaccid Paralysis ◽  
Paralytic Poliomyelitis ◽  
The Brain

Background: Acute flaccid paralysis (AFP) is defined by the acute onset of weakness or paralysis with reduced muscle tone in children. There are many non-infectious and infectious causes. Snake eye appearance (SEA) is a rare radiologic appearance and helps narrow down differential diagnoses in flaccid paralysis. Case Presentation: Here, we reported a 6 months-old girl who was admitted with sudden onset flaccid paralysis. She was lethargic and ill without any detectable deep tendon reflexes. She had a high fever that had started 3 days earlier with malaise, poor feeding and coryza. The first child of the family was a boy who expired with similar symptoms; however, the reason is still unknown. Her parents were relatives (cousins). The laboratory and cerebrospinal fluid tests analysis were normal. The brain MRI analysis revealed T1 dim Hypo intensity and T2 hyperintensity along with obvious ADC map hyperintensity in the brain stem. At first, the PCR tests analysis of stool samples for poliovirus and enterovirus were normal. Spinal MRI showed snake eye appearance and helped us narrow our differential diagnosis. We repeated the PCR tests of stool because of snake eye appearance in cervical MRI that was positive for poliovirus and indicated vaccine-associated Paralytic Poliomyelitis (VAPP). Unfortunately, she expired from vaccine associated poliomyelitis. Conclusion: Snake eye appearance is a rare radiologic appearance that can be seen in several pathological conditions; however, it is very rare in patients with acute flaccid paralysis. Radiology signs, especially in spinal cord MRI, can help recognizing abnormalities in images, and narrow the list of differential diagnosis in acute flaccid paralysis. Therefore, spinal cord MRI has an important role in the evaluation of patient with brain stem involvement in acute flaccid paralysis.

scholarly journals Familial Hypokalaemic Periodic Paralysis – A Case Report

1970 ◽  
Vol 27 (3) ◽  
pp. 166-168
Author(s):  
Md Shafayet Hasan Majumder
Keyword(s):  
Clinical Evidence ◽  
Positive Family History ◽  
Periodic Paralysis ◽  
Flaccid Paralysis ◽  
Ecg Changes ◽  
Recurrent Attack ◽  
Potassium Supplementation ◽  
Life Threatening ◽  
Channel Structures ◽  
Hypokalaemic Periodic Paralysis

Familial hypokalaemic periodic paralysis is a relatively uncommon but potentially life-threatening clinical condition. If recognized and treated appropriately during the episode, patients recover without any clinical sequellae. Reported case presented with recurrent attack of flaccid paralysis of limbs precipitated by carbohydrate meal. Familial periodic paralysis was diagnosed by clinical evidence of flaccid paralysis with positive family history and proved by ECG changes, biochemical findings and hypokalaemia in the absence of other causes of hypokalaemia. The patient improved dramatically with potassium supplementation. Understanding of the illness requires going through recent advances both in electrophysiology and in molecular biology of channelopathies, especially calcium channel structures, functions and genes. Key words: periodic paralysis, hypokalaemia. DOI:10.3329/jbcps.v27i3.4295 J Bangladesh Coll Phys Surg 2009; 27: 166-168

scholarly journals Acute muscular weakness in children

2017 ◽  
Vol 75 (4) ◽  
pp. 248-254 ◽  
Author(s):  
Ricardo Pablo Javier Erazo Torricelli
Keyword(s):  
Family History ◽  
Early Detection ◽  
Muscle Weakness ◽  
Neurological Examination ◽  
Pediatric Emergency ◽  
Periodic Paralysis ◽  
Toxic Substances ◽  
Muscular Weakness ◽  
Timely Manner ◽  
History Of

ABSTRACT Acute muscle weakness in children is a pediatric emergency. During the diagnostic approach, it is crucial to obtain a detailed case history, including: onset of weakness, history of associated febrile states, ingestion of toxic substances/toxins, immunizations, and family history. Neurological examination must be meticulous as well. In this review, we describe the most common diseases related to acute muscle weakness, grouped into the site of origin (from the upper motor neuron to the motor unit). Early detection of hyperCKemia may lead to a myositis diagnosis, and hypokalemia points to the diagnosis of periodic paralysis. Ophthalmoparesis, ptosis and bulbar signs are suggestive of myasthenia gravis or botulism. Distal weakness and hyporeflexia are clinical features of Guillain-Barré syndrome, the most frequent cause of acute muscle weakness. If all studies are normal, a psychogenic cause should be considered. Finding the etiology of acute muscle weakness is essential to execute treatment in a timely manner, improving the prognosis of affected children.

scholarly journals Anaesthesia challenges of a parturient with paramyotonia congenita and terminal filum lipoma presenting for labour and caesarean section under epidural anaesthesia – a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wei Shyan Siow ◽  
Wan-Ling Alyssa Chiew
Keyword(s):  
Case Report ◽  
Caesarean Section ◽  
Skeletal Muscles ◽  
Multidisciplinary Approach ◽  
Autosomal Dominant ◽  
Perioperative Complications ◽  
Periodic Paralysis ◽  
Paramyotonia Congenita ◽  
Case Presentation ◽  
History Of

Abstract Background Paramyotonia congenita is a rare autosomal dominant myopathy which presents with periodic weakness due to cold and exercise. It is caused by mutations of the SCN4 gene which encodes the sodium channel in skeletal muscles. Case presentation We report a full term obstetric patient with both paramyotonia congenita and terminal filum lipoma who presents for induction of labour followed by an emergency caesarean section performed under epidural anesthesia. Her recovery is subsequently complicated by a 3-day history of postpartum paraparesis attributed to hypokalemic periodic paralysis. Conclusion We describe the perioperative anesthesia considerations and challenges in this case with a review of the current literature. This case report highlights the importance of early proactive and collaborative multidisciplinary approach, maintaining normal temperature and electrolytes with a heightened vigilance for muscle-related perioperative complications.

scholarly journals Epidemiology of Acute Flaccid Paralysis in Hormozgan Province, Iran

2021 ◽  
Vol 10 (3) ◽  
pp. 86-90
Author(s):  
Ali Reza Moayedi ◽  
Ahmadagha Negahi ◽  
Seyed Hossein Asadi Yousefabad ◽  
Seyed Hossein Saadat ◽  
Mojtaba Salari ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Code Of Ethics ◽  
Age Groups ◽  
Sudden Onset ◽  
The Body ◽  
Flaccid Paralysis ◽  
World Health ◽  
Bandar Abbas ◽  
Health Organization ◽  
Vaccination Campaigns

Background: Acute flaccid paralysis (AFP) is a syndrome that occurs with the sudden onset of paralysis in any part of the body of infants and children under 15 years old. This study investigated the epidemiology and causes of AFP in patients under 15 years of age admitted to hospitals in Hormozgan province during 2011-2018. Materials and Methods: After receiving the code of ethics, the information of the studied patients was collected by referring to the health center of Hormozgan province and reviewing their records. The corresponding data were gathered using a checklist that included the causes of paralysis, age, gender, place of residence, and involved organs and then analyzed with SPSS software. Results: Out of 121 patients, 58.7% were males. In addition, 69.4% and 21.5% of these patients were in the age groups of 0-5 and 5-10 years, and the remaining cases were in the age group of 10-15 years. In terms of accommodation, 19.8% and 14.9% of patients lived in Bandar Abbas and Minab, respectively. The highest incidence of the disease was 19% and 18.2% in 2013 and 2015, respectively. The most affected organ was 57% of both feet. The most common cause of AFP in this study was Guillain-Barre syndrome (37.2%), followed by transient synovitis (17.4%). Conclusion: Considering the high annual incidence of this disease compared to the standard of the World Health Organization, it is recommended to launch training and vaccination campaigns to reduce the incidence and eradicate this disease.

scholarly journals Outcome of Patients with Gullain Barre syndrome at Tertiary Care Hospital in Eastern Nepal

2018 ◽  
Vol 6 (2) ◽  
pp. 20-24
Author(s):  
Dilli Ram Kafle ◽  
Surendra Shah
Keyword(s):  
Early Diagnosis ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Acute Flaccid Paralysis ◽  
Flaccid Paralysis ◽  
Care Hospital ◽  
Limb Weakness ◽  
Medical College ◽  
History Of ◽  
Tract Infections

Background: Gullain Barre syndrome is the most common cause of acute flaccid paralysis. Early diagnosis and treatment improves survival in patients with Gullain Barre Syndrome.Material and Methods: The purpose of the study was to note the common clinical features and identify predictors of outcome in Patients with Gullain Barre Syndrome. It is a prospective study which was conducted at Nobel Medical College Teaching Hospital from April 2015 to March 2016.Results: Time between onset of symptoms, presentation to hospital and admission was 5 ± 4 days. Four Patients (20%) gave history of upper respiratory tract infections and 12 (60%) had diarrhoea. Limb weakness was the most common symptom, which was documented in 20 (100%) patients. Other common symptoms were limb paresthesia, limb pain, and bladder dysfunction. Cerebrospinal Fluid protein was raised in 16(80%) patients to more than 45 mg/dl. All of our patients had CSF cell count less than 10. One (5%) patient had normal nerve conduction study initially. Eight (40%) patients had axonal (AMAN) variant of GBS, 3(15%) had AMSAN variant of GBS, while 8(40%) had demyelinating neuropathy (AIDP). The mean duration of hospital stay was7.4 ±2.7 days. Three months after hospital discharge 12(60%) patients achieved complete recovery. Eight (40%) patients still needed some support with ambulation. Predictors of worse outcome were old age, rapid progression of disease and AMSAN variant of GBS.Conclusion: Gullain Barre syndrome is an important cause of acute flaccid paralysis in children and adults. Early diagnosis is based on history of symmetrical limb weakness, CSF Findings and nerve conduction study. Majority of patients improve with supportive care while some develop respiratory failure and needs mechanical intubation. Journal of Nobel Medical College Volume 6, Number 2, Issue 11 (July-December, 2017) Page:20-24

scholarly journals Acute flaccid paralysis: An approach to diagnosis

2017 ◽  
Vol 13 (2) ◽  
pp. 164-169
Author(s):  
Ashok Kumar Yadav ◽  
P Bhattarai ◽  
B Aryal ◽  
PP Gupta ◽  
S Chaudhari ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Flaccid Paralysis ◽  
Expectant Management ◽  
Acute Onset ◽  
The Body ◽  
Flaccid Paralysis ◽  
Emergency Ward ◽  
Common Presentation ◽  
History Of

Acute flaccid paralysis (AFP) is a common presentation to the emergency department and can present with paralysis of single to several limbs. Here is a case with AFP presented to highlight the approach to diagnosis. A 25 years male who recently returned from Malaysia presented to the emergency ward with acute onset of paralysis for two days which was progressive and was gradually involving the chest muscles as well. He had a history of loose mucoid stool since 4-5 days but there were no rashes or exanthema in the body. On complete examination, apart from diminished power in all the limbs, there were no other positive findings. He was started on expectant management and no other medications except multivitamins were prescribed. Patient was discharged home on patient party’s request and on follow-up after 14 days, patient's had improved.Health Renaissance 2015;13(2): 164-169

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