Table 5.

Principles of Treatment for Individuals with HypoPP

GoalMeansPractical Details
To avoid triggering or aggravating factors for paralytic attacksAvoid:
  • Strenuous effort;
  • Prolonged immobility;
  • Carbohydrate-rich diet;
  • High sodium diet.
  • Monitor episodes of weakness noting time of day & specific triggers.
  • Provide dietary review/counseling.
Treatment of paralytic attack:
  • Shorten/prevent aggravation of the weakness episode.
  • Normalize kalemia.
  • Provide potassium supplementation (oral, or IV if oral impossible or if potassium very low).
  • Avoid glucose intake.
  • Do not use slow-release forms of potassium.
  • Oral potassium: initially, 1 mEq/kg; add 0.3 mEq/kg after 30 min if no improvement
  • IV potassium: 0.3 mEq/kg/h
Preventive treatment for paralytic attacksDaily potassium supplementationSlow-release forms of potassium may be used.
Acetazolamide
Dichlorphenamide
Potassium-sparing diuretics
Preventive treatment for late-onset myopathyAcetazolamide?
Medical precautions
  • Avoid corticosteroids if possible.
  • Use alpha- or beta adrenergic drugs w/caution, even in local anesthesia or ophthalmology.
Other elements of management
  • Kinesiotherapy in case of long-lasting pelvic deficit
  • Adaptive measures: (1) at school & especially for sports; (2) in work setting

From: Hypokalemic Periodic Paralysis

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