Hyperkalemic periodic paralysis.

IN 1886 Eulenberg 1 described "paramyotonia congenita," an inherited syndrome in which episodes of myotonia and weakness were induced by exposure to cold. A similar condition was reported independently by Rich. 2 During the ensuing years additional cases were published, emphasizing the myotonia rather than the episodic weakness which was also part of Eulenberg's original description. A link with periodic paralysis was not considered until 1957, when French and Kilpatrick 3 studied a patient with paramyotonia who was subject to attacks of generalized weakness. An oral dose of potassium chloride induced an attack of weakness lasting several days, without a fall in the serum potassium level. Just prior to the report of French and Kilpatrick, Helweg-Larsen et al 4 in Denmark and Gamstorp 5 in Sweden described a hyperkalemic form of periodic paralysis, "adynamia episodica hereditaria." Myotonia was not mentioned in these Scandinavian cases, but paralysis could be induced by

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