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Acute quadriplegia from hyperkalemia: a case report and literature review.
MedLine Citation:
PMID:  21150391     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Hyperkalemia has been described as a rare and under recognized cause of acute quadriplegia.
CASE REPORT: A 52-year-old man with end-stage renal disease presented with ascending quadriplegia and dyspnea for 2 days. He had life-threatening hyperkalemia (9.0 mEq/L). His electrocardiogram showed typical features of hyperkalemia. His symptoms improved in 30 minutes and completely resolved in 5 hours after emergent treatment of hyperkalemia. He admitted eating large amounts of high potassium foods and taking ibuprofen in uncertain quantities. We reviewed 62 articles and identified 73 patients with secondary hyperkalemic paralysis. Common presentations were diminished reflexes, quadriparesis/paralysis, respiratory involvement, and sensory loss. Almost half of all patients had potassium levels higher than 9 mEq/L. Complete recovery, achieved in 89% of patients, did not correlate either with the absolute potassium level or the degree to which it was corrected.
CONCLUSIONS: Hyperkalemia is a rare but treatable cause of acute flaccid paralysis that requires immediate treatment. Late diagnosis can delay appropriate treatment leading to cardiac arrhythmias and arrest.
Authors:
Kessarin Panichpisal; Shefali Gandhi; Kenneth Nugent; Yaacov Anziska
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The neurologist     Volume:  16     ISSN:  1074-7931     ISO Abbreviation:  Neurologist     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-12-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9503763     Medline TA:  Neurologist     Country:  United States    
Other Details:
Languages:  eng     Pagination:  390-3     Citation Subset:  IM    
Affiliation:
* Department of Neurology, Downstate Medical Center, State University of New York, New York, NY † Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX.
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