A Case of Thyrotoxic Periodic Paralysis: A Rare Cause of Hypokalemia and Importance of Beta Blockers

Thyrotoxic periodic paralysis (TPP) is a complication of hyperthyroidism that is characterized by increased Na+/K+-ATPase activity. It can present with weakness and paralysis due to massive intracellular shift of potassium.Although potassium replacement is given emergently for TPP treatment, it is also important to suppress hyperadrenergic activity as it is responsible for the pathophysiology of the disease. Use of beta blockers is a safe and effective therapeutic option in order to suppress hyperadrenergic activity during an attack. In this case report, we describe a TPP patient who developed acute tetraplegia in hours despite the potassium replacement therapy and we discuss the role of beta blockers in the treatment of TPP.