Hypokalemic periodic paralysis exacerbated by acetazolamide

Although acetazolamide usually prevents paralytic attacks in hypokalemic periodic paralysis, not all patients benefit from this treatment. We studied a father and two sons in whom attack frequency and severity increased on acetazolamide. Administration of triamterene virtually abolished attacks in three separate single-blind trials totaling more than 12 months. Spontaneous and glucose-insulin provoked attacks occurred with only slight hypokalemia. Acetazolamide produced slight hypokalemia and provoked attacks of weakness whereas triamterene increased potassium levels significantly. Certain patients with hypokalemic periodic paralysis are worsened by acetazolamide, perhaps because of its kaliopenic effect. Triamterene may be effective in some of these patients.

[1]  R. Griggs,et al.  Regulation of plasma potassium in hyperkalemic periodic paralysis , 1979, Neurology.

[2]  H. Beck-Nielsen,et al.  Insulin receptors, insulin secretion, and glucose disappearance rate in patients with periodic hypokalaemic paralysis. , 1979, Acta endocrinologica.

[3]  R. Griggs,et al.  Chapter 6: Diagnosis and Treatment of the Periodic Paralyses , 1979 .

[4]  J. Raphael,et al.  [Periodic familial paralysis with hypokalemia. Hemodynamic and metabolic studies: favourable effect of acetazolamide (author's transl)]. , 1978, Revue neurologique (Paris).

[5]  B. Saltin,et al.  Skeletal muscle characteristics and carbohydrate metabolism after glucose loading in hypokalaemic periodic paralysis. , 1978, Scandinavian journal of clinical and laboratory investigation.

[6]  R. Griggs,et al.  Decreased insulin sensitivity of forearm muscle in myotonic dystrophy. , 1978, The Journal of clinical investigation.

[7]  T. Johnsen.  EFFECT UPON SERUM INSULIN, GLUCOSE AND POTASSIUM CONCENTRATIONS OF ACETAZOLAMIDE DURING ATTACKS OF FAMILIAL PERIODIC HYPOKALEMIC PARALYSIS , 1977, Acta neurologica Scandinavica.

[8]  R. Griggs,et al.  Acetazolamide-induced weakness in paramyotonia congenita. , 1977, Annals of internal medicine.

[9]  R. Griggs.  The myotonic disorders and the periodic paralyses. , 1977, Advances in neurology.

[10]  G. Forbes,et al.  Urinary creatinine excretion and lean body mass. , 1976, The American journal of clinical nutrition.

[11]  J. Chaco,et al.  Acetazolamide treatment in hypokalemic periodic paralysis: A metabolic and electromyographic study , 1973, American Journal of the Medical Sciences.

[12]  D. Capuzzi,et al.  Hyperkalemia after triamterene in diabetic patients , 1972, Clinical pharmacology and therapeutics.

[13]  S. Sharma.  Observations on a case of familial periodic paralysis. , 1971, Journal of Association of Physicians of India.

[14]  W. Engel,et al.  Acetazolamide treatment of hypokalemic periodic paralysis. Prevention of attacks and improvement of persistent weakness. , 1970, Annals of internal medicine.

[15]  W. Engel,et al.  Acetazolamide prophylaxis in hypokalemic periodic paralysis. , 1968, The New England journal of medicine.

[16]  M. Glynn,et al.  BODY COMPOSITION IN HYPOKALEMIC FAMILIAL PERIODIC PARALYSIS * , 1963, Annals of the New York Academy of Sciences.

[17]  G. R. Tudhope,et al.  Triamterene, a new diuretic drug. I. Studies in normal men and in adrenalectomized rats. , 1962, British medical journal.

[18]  P. Rowley,et al.  Studies in familial periodic paralysis , 1961 .

[19]  K. Zierler,et al.  Movement of potassium into skeletal muscle during spontaneous attack in family periodic paralysis. , 1957, The Journal of clinical investigation.

[20]  I. Mcquarrie,et al.  Hereditary periodic paralysis. II. Effects of fasting and of various types of diet on occurrence of para lytic attacks. , 1952, Metabolism: clinical and experimental.