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proximal muscular weakness

Posted In: Medical Stories 6 Replies
  • Posted By: Anonymous
  • July 18, 2008
  • 09:47 PM

29 year old female non smoker non alcoholic without any previous diseases
c\o difficulty with lifting her hands (useing the comb and house jobs)
and difficulty standing from setting and these symptoms were progressive over about 1 week . no vomiting no diarrhea no fever no abdominal pain no any other symptoms drug history negative
examination : proximal weakness of limbs (power4/5 in all limbs)
sensory examination normal tendon reflexes were increased
no other abnormalities were detected by clinical examination
serum k: 2.4
serum ca 1.8 mmol/l
LFT and RFT NORMAL CBC normal serum sugar normal serum albumin normal
ECG flat T in most leads
pt was diagnosed firstly hypokalamic periodic paralysis and treated with iv chloride potasium without improvement then serum mg was done and result 0.7mmol/l ABG MRTABOLIC ALKALOSIS PH 7.5
BLOOD PRESSURE recordings between 140/80 and 150/90 then patien was given mg sulfate chloride potasium and aldacton 100mg/ day
then serumk k between 3 and 3.8 serum mg 1mmol/l
with improvement in muscle weakness

what is the diagnosis

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6 Replies:

  • Your diagnosis still may be hypokalemic periodic paralysis. On the first attempt to correct potassium with potassium chloride, the pt was still hypomagnesimic, so any attempts to correct hypokalemia would fail. Once magnesium was corrected, the second administration of potassium chloride was therapeutic and resolution of symptoms (prox muscle weakness, etc) occured. PS I don't know if the calcium level that you report is compatible with human existence. You might want to verify that.
    fewd4thought 126 Replies Flag this Response
  • if the diagnosis is hypokalamic periodic paralysis so what is the cause of hypomagnesemia ?In our lab the normal limits of serum ca 2- 2.4 mmol/l
    Anonymous 42789 Replies Flag this Response
  • For hypomag, must r/o:1.) Microwave/ electromagnet radiation disease2.) Lyme Disease3.) Babesia/ Brucelleosis/ Tuleremia4.) MS5.) Chronic Fatigue Syndrome Don't be satisfied with what your doctor says! You have LYME! You probably also have MICROWAVE DISEASE! Step AWAY FROM YOUR COMPUTER!!! I had every single one of these diseases and it took me 15 years to get the treatment I needed. I had to buy an MRI machine and put it in my backyard and scan myself on the weekend while my dog ran gadolinium protocols. Fight for your diagnosis.
    fewd4thought 126 Replies Flag this Response
  • Fewd4thought, I thought you were a doctor in Texas....Are you for real?
    Abbydoodle 138 Replies Flag this Response
  • No. I am sarcastic.
    fewd4thought 126 Replies Flag this Response
  • Fewd4thought, Good, that means my brain is functioning today. Sometimes it does not. So I caught it. Either that or I wanted your dog to talk to my four dogs, they are slacking off too much.:D
    Abbydoodle 138 Replies Flag this Response
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