Paralisia periodica tireotoxica: registro de um caso

Torres, Athos Scherer; Medina, Gualberto R. M.; Dietrich, Alberto; Coutinho, Mario F.; Santos, Odilon Dutra dos

doi:10.1590/S0004-282X1979000200010

Resumos

É relatado um caso de paralisia periódica tireotóxica. Os autores chamam a atenção para o fato de não haver registro de publicações semelhantes na literatura brasileira nos 10 últimos anos. São abordados diversos aspectos do diagnóstico diferencial com outros tipos de paralisia periódica.

A case of thyrotoxic periodic paralysis based on clinical grounds, laboratory data and therapeutic response as well is reported. The authors comment on the differential diagnosis with the most frequent types of periodic paralysis. The importance of a correct diagnosis and treatment as early as possible is stressed as to prevent further development of permanent paralysis due to irreversible degenerative myofibril changes as stated in literature.

Paralisia periodica tireotoxica: registro de um caso

Thyrotoxic periodic paralysis: a case report

Athos Scherer Torres^I; Gualberto R. M. Medina^II; Alberto Dietrich^III; Mario F. Coutinho^IV; Odilon Dutra dos Santos^II

^IChefe de Clínica. Serviço de Neurologia e Neurocirurgia Dr. Mario Coutinho, Hospital Beneficência Portuguesa (Porto Alegre)

^IIMédicos Residentes. Serviço de Neurologia e Neurocirurgia Dr. Mario Coutinho, Hospital Beneficência Portuguesa (Porto Alegre)

^IIIEndocrinologista. Serviço de Neurologia e Neurocirurgia Dr. Mario Coutinho, Hospital Beneficência Portuguesa (Porto Alegre)

^IVChefe do Serviço. Serviço de Neurologia e Neurocirurgia Dr. Mario Coutinho, Hospital Beneficência Portuguesa (Porto Alegre)

RESUMO

É relatado um caso de paralisia periódica tireotóxica. Os autores chamam a atenção para o fato de não haver registro de publicações semelhantes na literatura brasileira nos 10 últimos anos. São abordados diversos aspectos do diagnóstico diferencial com outros tipos de paralisia periódica.

SUMMARY

A case of thyrotoxic periodic paralysis based on clinical grounds, laboratory data and therapeutic response as well is reported. The authors comment on the differential diagnosis with the most frequent types of periodic paralysis. The importance of a correct diagnosis and treatment as early as possible is stressed as to prevent further development of permanent paralysis due to irreversible degenerative myofibril changes as stated in literature.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Trabalho do Serviço de Neurologia e Neurocirurgia Dr. Mario Coutinho, Hospital Beneficência Portuguesa (Porto Alegre).

Serviço de Neurologia e Neurocirurgia Or, Mario Coutinho - Hospital Beneficência Portuguesa - Avenida Independência - 900QO Porto Alegre, RS - Brasil.

1. ALBEAUX-FERNET, M. - Myopathies et hyperthyroidie. Sem. Hop. Paris 28:1720, 1966.
2. ALI, K. - Hypokalemic periodic paralysis complicating thyrotoxicosis, British Med. J. 4:503, 1975.
3. AU, K. S. - Thyrotoxic periodic paralysis. Arch. Neurol. Chicago 26:543, 1972.
4. BRODY, I. A. & DUDLEY, A. W. - Thyrotoxic hypokalemic periodic paralysis. Arch. Neurol. (Chicago) 21:1, 1969.
5. CONWAY, M. J.; SEIBEL, J. A. & EATON, P. - Thyrotoxicosis and periodic paralysis: improvement with beta adrenergic blockade. Ann. Intern. Med. 81:332, 1974.
6. DYKEN, M. I. & TIMMONS, g. D. - Hiperkalemic periodic paralysis with hypocalcemic episode. Arch. Neurol. (Chicago) 9:76, 1963.
7. ENGEL, A. G.; LAMBERT, E. H.; ROSEVEAR, J. W. & TAUXE, N. - Clinical and electromyographic studies in a patient with prymary hypokalemic periodic paralysis. Amer. J. Med. 38:626, 1965.
8. ENGEL, A. G. - Electron microscopic observation in thyrotoxic and corticosteroid induced myopathies. Mayo Clin. Pro. 41:785, 1966.
9. ENGEL, A. G. - Electron microscopic observations in primary hypokalemic and thyrotoxic periodic paralysis. Mayo Clin. Proc. 41:797, 1966.
10. HARRISON, T. H. - Harrison's Principles of Internal Medicine. Mcgraw-Hill Book Co. New York, 1970.
11. KUSAKABE, T.: YOSHIDA, M. & NISHIKAWA, M. - Thyrotoxic periodic paralysis: a peculiar case with unusual dystonic behavior and variable relations of paralysis to serum potassium levels. J. Clinic. Endocrinol. Metab. 43:730, 1976.
12. LENORMAND, M. W.; GRAVELEAU, J.; LAFONT, J. & MORIN, M. - Les myopathies hyperthioidiennes: a propôs de trois observations. Sem. Hop. Paris 51:2031, 1975.
13. McDONALD, R. N.; REWCASTLE, N. B. & HUMPHREY, J. G. - The myopathy of hyperkalemic periodic paralysis. Arch. Neurol. (Chicago) 19:274, 1968.
14. McCARDLE, B. - Familial periodic paralysis. British Med. Bull. 12:226, 1956.
15. McFADSEAN, A. J. S. & YEAUNG, R. - Periodic paralysis complicating thyrotoxicosis in Chinese. British Med. 1:451, 1967.
16. MERUIT, H. H. - A Textbook of Neurology. Lea & Febiger, Philadelphia, 1973.
17. MURIE, N.; SIMON, M.; EDAN, R.; SABBURAUD, O. & BOUREL, M. - Hyperthioidie et paralisie périodique. Sem. Hop. Paris 47:1069, 1971.
18. NORRIS, F. H.; PANNER, B. J. & STORMONT, J. M. - Thyrotoxic periodic paralysis. Arch. Neurol. (Chicago) 19:88, 1968.
19. ODOR, D. L.; PATEL, A. N. & PEARCE, L. A. - Familial hypokalemic periodic paralysis with permanent myopathy: a clinical and ultrastructural study. J. Neuropath. Exp. Neurol. 26:98, 1967.
20. PEARSON, C. M. - The periodic paralysis: differential features and pathological observations in permanent myopathic weakness. Brain 87:341, 1964.
21. PIMSTONE, N.; MARINE, N. & PIMSTONE, B. - Beta-adrenergic blockade in thyrotoxic myopathy. Lancet 2:1219, 1968.
22. ROWLAND, L. P.; FAH. S. & SCHOTLAND, D. L. - McCardle's disease. Arch. Neurol. (Chicago) 9:13, 1963.
23. SHISHIBA, Y.; SHIMIZU, T.; SAITO, T. & SHIZUME, K. - Elevated immuno-reactive insulin concentration during spontaneous attacks in thyrotoxic periodic paralysis. Metabolism. 21:285, 1972.
24. SHIZUME, K.; SHISHIBA, Y.; SKUMA, M.; YAMAUCHI, H.; NAKO, K. & OKINARA, S. - Studies on electrolyte metabolism and idiopathic and thyrotoxic periodic paralysis. Metabolism 15:138, 1966.
25. SWAIMAN, K. F. & WRIGHT, F. S. - Enfermedades Neuromusculares en el Lactante y el Nino. Versão castelhana. Editorial Pediátrica, Barcelona, 1972.
26. YEANG, R. T. T. & TSE, T. F. - Thyrotoxic periodic paralysis: effect of propranolol. Amer. J. Med. 57:584, 1974.

Datas de Publicação

Publicação nesta coleção
24 Ago 2012
Data do Fascículo
Jun 1979

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ALBEAUX-FERNET, M. - Myopathies et hyperthyroidie. Sem. Hop. Paris 28:1720, 1966.

[2] 2. ALI, K. - Hypokalemic periodic paralysis complicating thyrotoxicosis, British Med. J. 4:503, 1975.

[3] 3. AU, K. S. - Thyrotoxic periodic paralysis. Arch. Neurol. Chicago 26:543, 1972.

[4] 4. BRODY, I. A. & DUDLEY, A. W. - Thyrotoxic hypokalemic periodic paralysis. Arch. Neurol. (Chicago) 21:1, 1969.

[5] 5. CONWAY, M. J.; SEIBEL, J. A. & EATON, P. - Thyrotoxicosis and periodic paralysis: improvement with beta adrenergic blockade. Ann. Intern. Med. 81:332, 1974.

[6] 6. DYKEN, M. I. & TIMMONS, g. D. - Hiperkalemic periodic paralysis with hypocalcemic episode. Arch. Neurol. (Chicago) 9:76, 1963.

[7] 7. ENGEL, A. G.; LAMBERT, E. H.; ROSEVEAR, J. W. & TAUXE, N. - Clinical and electromyographic studies in a patient with prymary hypokalemic periodic paralysis. Amer. J. Med. 38:626, 1965.

[8] 8. ENGEL, A. G. - Electron microscopic observation in thyrotoxic and corticosteroid induced myopathies. Mayo Clin. Pro. 41:785, 1966.

[9] 9. ENGEL, A. G. - Electron microscopic observations in primary hypokalemic and thyrotoxic periodic paralysis. Mayo Clin. Proc. 41:797, 1966.

[10] 10. HARRISON, T. H. - Harrison's Principles of Internal Medicine. Mcgraw-Hill Book Co. New York, 1970.

[11] 11. KUSAKABE, T.: YOSHIDA, M. & NISHIKAWA, M. - Thyrotoxic periodic paralysis: a peculiar case with unusual dystonic behavior and variable relations of paralysis to serum potassium levels. J. Clinic. Endocrinol. Metab. 43:730, 1976.

[12] 12. LENORMAND, M. W.; GRAVELEAU, J.; LAFONT, J. & MORIN, M. - Les myopathies hyperthioidiennes: a propôs de trois observations. Sem. Hop. Paris 51:2031, 1975.

[13] 13. McDONALD, R. N.; REWCASTLE, N. B. & HUMPHREY, J. G. - The myopathy of hyperkalemic periodic paralysis. Arch. Neurol. (Chicago) 19:274, 1968.

[14] 14. McCARDLE, B. - Familial periodic paralysis. British Med. Bull. 12:226, 1956.

[15] 15. McFADSEAN, A. J. S. & YEAUNG, R. - Periodic paralysis complicating thyrotoxicosis in Chinese. British Med. 1:451, 1967.

[16] 16. MERUIT, H. H. - A Textbook of Neurology. Lea & Febiger, Philadelphia, 1973.

[17] 17. MURIE, N.; SIMON, M.; EDAN, R.; SABBURAUD, O. & BOUREL, M. - Hyperthioidie et paralisie périodique. Sem. Hop. Paris 47:1069, 1971.

[18] 18. NORRIS, F. H.; PANNER, B. J. & STORMONT, J. M. - Thyrotoxic periodic paralysis. Arch. Neurol. (Chicago) 19:88, 1968.

[19] 19. ODOR, D. L.; PATEL, A. N. & PEARCE, L. A. - Familial hypokalemic periodic paralysis with permanent myopathy: a clinical and ultrastructural study. J. Neuropath. Exp. Neurol. 26:98, 1967.

[20] 20. PEARSON, C. M. - The periodic paralysis: differential features and pathological observations in permanent myopathic weakness. Brain 87:341, 1964.

[21] 21. PIMSTONE, N.; MARINE, N. & PIMSTONE, B. - Beta-adrenergic blockade in thyrotoxic myopathy. Lancet 2:1219, 1968.

[22] 22. ROWLAND, L. P.; FAH. S. & SCHOTLAND, D. L. - McCardle's disease. Arch. Neurol. (Chicago) 9:13, 1963.

[23] 23. SHISHIBA, Y.; SHIMIZU, T.; SAITO, T. & SHIZUME, K. - Elevated immuno-reactive insulin concentration during spontaneous attacks in thyrotoxic periodic paralysis. Metabolism. 21:285, 1972.

[24] 24. SHIZUME, K.; SHISHIBA, Y.; SKUMA, M.; YAMAUCHI, H.; NAKO, K. & OKINARA, S. - Studies on electrolyte metabolism and idiopathic and thyrotoxic periodic paralysis. Metabolism 15:138, 1966.

[25] 25. SWAIMAN, K. F. & WRIGHT, F. S. - Enfermedades Neuromusculares en el Lactante y el Nino. Versão castelhana. Editorial Pediátrica, Barcelona, 1972.

[26] 26. YEANG, R. T. T. & TSE, T. F. - Thyrotoxic periodic paralysis: effect of propranolol. Amer. J. Med. 57:584, 1974.