Thyrotoxic periodic paralysis

Thyrotoxic periodic paralysis (TPP) is an uncommon disorder characterized by simultaneous thyrotoxicosis, hypokalaemia, and paralysis and is the most common acquired form of periodic paralysis. It is usually associated with low plasma potassium levels and is often precipitated by physical activity or ingestion of carbohydrates. We reported two the cases with hyperthyroidism who applied to the emergency department with episode of flaccid quadriparalyis and the literature on this subject. In the both cases, physical and laboratory examination revealed the low serum potassium levels, sinus tachycardia and ST segment depression, diffuse goiter, flaccid quadriparalysis. Potassium chloride was applied via parenteral and oral. Meanwhile antithyroid treatment (propylthiouracil and propranolol) were given to they. In first patient, it was determined that intake of high dose diclophenac sodium was the probable precipitating factor. In the both cases, paralysis began to improve in 30 minutes and had completely resolved within about 8-10 hours of admission. Thyrotoxic periodic paralysis should be taken into consideration in the differential diagnosis of all acute episodes of motor paralysis especially in young patients. Thyrothoxic periodic paralysis is treated with cautious replacement of potassium and achievement of an euthyroid state. Early diagnosis is important for planning antithyroid treatment, protecting the patient from further episodes of paralysis and avoidance of precipitating factors.