EM@3AM: Thyrotoxic Periodic Paralysis
A 28-year-old otherwise healthy male presents for an acute episode of bilateral lower extremity weakness causing him to fall in the bathroom. The episode started approximately 30 minutes prior to arrival. He had a similar episode three months prior which resolved quickly during his ED visit. Neuro exam includes intact sensation in all distributions to light touch. Hip flexion ⅖ bilaterally, knee extension ⅗ bilaterally, plantar and dorsiflexion ⅘. Bilateral upper extremities shoulder flexion, elbow flexion, and extension 5/5. Labs reveal low potassium, phosphate, magnesium, TSH.
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