SHM Converge Scientific Abstract ePoster Gallery-From Lower to Upper, Resolved by Supper

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This clinical vignette describes an 18-year-old male who developed sudden ascending flaccid paralysis over 24 hours after a carbohydrate-rich meal. He had a prior similar ICU admission and a family history of milder episodes in his father and grandfather. Examination showed profound weakness with absent reflexes but preserved sensation and intact cranial nerves. Labs revealed severe hypokalemia (K 1.7 mmol/L), mild hypomagnesemia, and ECG changes consistent with hypokalemia. Thyroid testing was normal, and urine potassium studies supported potassium redistribution rather than loss.<br /><br />He was diagnosed with hypokalemic periodic paralysis (HPP), likely familial, and later found to have an SCN4A gene mutation. After receiving oral and intravenous potassium, he briefly developed rebound hyperkalemia to 6.2 mmol/L, which resolved quickly. His weakness improved as potassium normalized, and he recovered fully within 24 hours. He was discharged on eplerenone and potassium supplementation.<br /><br />The report emphasizes that HPP is a rare disorder, often triggered by high carbohydrate intake, stress, or exercise, and typically presents with episodic proximal muscle weakness and marked hypokalemia. Acute management requires cautious potassium replacement because rapid overcorrection can cause dangerous hyperkalemia. The authors also highlight the importance of distinguishing HPP from other causes of ascending paralysis, including Guillain-Barré syndrome, thyrotoxic periodic paralysis, and myasthenia gravis. Early recognition, careful electrolyte monitoring, and awareness of triggering factors are key to preventing complications.

Asset Subtitle

Ankita C. Yelamanchili

Meta Tag

Author List Ankita C. Yelamanchili, Bruno Alvarez Concejo

Category Clinical Vignettes

Concept Hypokalemic Periodic Paralysis

Concept Muscle Weakness

Concept Hypokalemia

Concept Potassium Repletion

Concept Hyperkalemia

Distinguished Non-Finalist

Presenter Organization LSU Health Shreveport

Presenting Author Ankita C. Yelamanchili

Track Adult

Keywords

hypokalemic periodic paralysis

ascending flaccid paralysis

severe hypokalemia

SCN4A mutation

familial periodic paralysis

carbohydrate-rich meal

potassium redistribution

rebound hyperkalemia

electrolyte monitoring

muscle weakness

Hypokalemic Periodic Paralysis

Muscle Weakness

Hypokalemia

Potassium Repletion

Hyperkalemia