Advanced Practice Spotlight
Hypokalemic Periodic Paralysis Secondary to Dexamethasone Injection

https://doi.org/10.1016/j.jen.2018.09.012Get rights and content

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Case Report

A 27-year-old white man presented to the emergency department via private vehicle with a report of paralysis below the neck that began approximately 12 hours prior to arrival. The patient stated that he woke up the previous night and was able to move his fingers and toes but had paralysis in the remainder of his extremities; sensation remained intact. He described 2 previous instances of extremity weakness and paralysis that resolved spontaneously within several hours. He never sought medical

Discussion

Muscle weakness and paralysis are not uncommon presentations in any emergency department, and patients present with these signs and symptoms as a result of a variety of etiologies. Episodic weakness is often seen as a result of renal, gastrointestinal, or other underlying systemic disease. Frequent causes of abrupt-onset paralysis include Guillain-Barré syndrome, transverse myelitis, medication overdose, and electrolyte imbalance. Thyrotoxic periodic paralysis closely mimics HPP and must be

Conclusion

Although rare, HPP can be seen in patients presenting to the emergency department with acute-onset muscle weakness or paralysis. This case illustrates the challenges of determining an effective diagnostic and treatment strategy with the plethora of primary and secondary causes for acute paralysis. Early identification and treatment can mitigate adverse cardiac, renal, and neurologic complications. Management of risk factors is essential in preventing or minimizing recurrence. It is essential to

J. Casey Elkins is Assistant Professor, University of South Alabama, Mobile, AL.

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J. Casey Elkins is Assistant Professor, University of South Alabama, Mobile, AL.

Earn Up to 7.5 Hours. See page 109.

Section Editors: Cindy D. Kumar, MSN, RN, AG-ACNP-BC, FNP-BC, ENP-C, and Darleen A. Williams, DNP, CNS, CEN, CCNS, CNS-BC, EMT-P

Submissions to this column are encouraged and may be sent to Cindy D. Kumar, MSN, RN, AG-ACNP-BC, FNP-BC, ENP-C [email protected] or Darleen A. Williams, DNP, CNS, CEN, CCNS, CNS-BC, EMT-P [email protected]

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