A STUDY ON MECHANISM OF ATTACK OF PERIODIC PARALYSIS

SUMMARY OF 10 CASES OF PERIODIC PARALYSIS ASSOCIATED WITH HYPERTHYROIDISM

Abstract

Ten cases of periodic paralysis associated with hyperthyroidism were studied. Demonstration of the induction of attacks in all ten individuals by the administration of glucose, insuline and cortisone was shown and the conclusions were as follows:
1) In clinical course, disappearance of spontaneous attacks of paralysis with cure of the hyperthyroidism was observed in all ten cases, and the attacks did not occur even provocation in 4 cases, and developed again by recurrence of hyperthyroidism in 2 cases. From these data, it was concluded that there is definite evidence of a relationship between periodic paralysis and hyperthyroidism.
2) Concerning attacks of paralysis, the essential phenomenon is that, of an abnormal acceleration of carbohydrate metabolism caused by hyperthyroidism. The attacks were associated with a remarkable fall of serum potassium and phosphorus, which was reflected in an increased intake of potassium and phosphorus by the cells.
3) Cholinesterase activities of corpuscle and plasma in the blood did not increase. Electromyographic findings showed a low amplitude of neuromuscular unit voltage, but histological findings of muscle during attacks showed no pathological features.
4) In eight cases, electrocardiographic findings sufficiency agreed with changes in hypokalemia.
5) Mechanisms of attacks of paralysis is infered as follows:(Attacks stimulating procedures)