Pediatric periodic normokalemic paralysis
Introduction
Brief introduction of periodic normal blood potassium paralysis in children Periodic paralysis is a group of metabolic diseases related to potassium metabolism. It is a continual, self-limiting episode of skeletal muscle flaccid paralysis or weakness. It lasts for several hours to several weeks. Characteristics of the disease. According to the change of blood potassium at the time of onset, it can be divided into three types: hypokalemia type, hyperkalemia type and normal blood potassium type. Periodically normal blood potassium paralysis (normokalemic peripheral disorder) is autosomal dominant, and blood potassium is normal at the time of onset. basic knowledge Probability ratio: 5% of specific population Susceptible people: children Mode of infection: non-infectious complication:
Cause
The cause of periodic normal blood potassium paralysis in children
(1) Causes of the disease
Foreign reports have periodic family history, autosomal dominant inheritance, high penetrance rate, and extremely rare family history in China.
(two) pathogenesis
The pathogenesis is still unclear. It is generally believed that the concentration of potassium ions is related to fluctuations inside and outside the cell. Except for thyroid and adrenal gland, which may be the pathogenesis of the disease, many of the effects on glucose metabolism, water and electrolyte balance are also affected. It can cause similar episodes of periodic paralysis. In short, potassium and glucose metabolism disorders are the main aspects of the pathogenesis of this disease; there is also a complex relationship between endocrine dysfunction and myasthenia gravis.
Prevention
Periodical normal blood potassium paralysis prevention in children
On weekdays, avoid eating foods containing more potassium, such as meat, bananas, spinach, and potatoes, avoid using potassium preparations, prevent overwork or excessive muscle activity, and pay attention to the effects of cold or heat.
Complication
Children with periodic normal blood potassium paralysis complications Complication
There are generally no serious complications.
Symptom
Children with periodic normal blood potassium paralysis symptoms Common symptoms Paralyzed facial muscles unable to swallow difficult muscle pain palpitation
It is easy to cause seizures in the morning or after intense exercise. Walking or slight exercise can sometimes prevent paralysis. This disease can be diagnosed according to the onset of weakness and normal serum potassium. The oral administration of potassium chloride can induce paralysis and increase it. It can be effectively treated with sodium chloride. The duration of the attack can be from several days to several weeks, more than 10 days. In addition to facial muscle spasm, there are often facial muscle weakness, chewing weakness, difficulty swallowing, low voice and other symptoms. . Both potassium and urinary potassium were normal at the time of onset.
Examine
Examination of periodic normal blood potassium paralysis in children
The blood potassium test is in the normal range at the time of onset, and the urinary potassium is also in the normal range.
The electrocardiogram showed no hypokalemia or high potassium performance, which was a normal electrocardiogram. The electromyogram showed that the motor potential time was reduced and the amplitude was reduced.
Diagnosis
Diagnosis and differential diagnosis of periodic normal blood potassium paralysis in children
It can be diagnosed according to the following characteristics:
1. There has been a history of similar attacks in the past.
2. There are predisposing factors: such as cold, rest after exercise, hunger, emotional stress, taking potassium salt and other predisposing factors.
3. Limb symmetry flaccid paralysis: acute or subacute onset of limb symmetry flaccid paralysis, characterized by lower limb weight, upper limbs light, proximal end, and distal distal.
4. Other symptoms: Some patients may have thirst, palpitation and muscle pain.
5. Laboratory examination: blood potassium and urinary potassium are normal at the time of onset.
6. ECG examination: ECG examination is normal.
7. Electromyography examination: It indicates that the potential amplitude is reduced and the number is decreased. When the total sputum is removed, the motor unit potential disappears and the electrical stimulation has no response.
It is differentiated from hypokalemia type periodic sputum and hyperkalemia type periodic sputum.
