What Is Hypokalemic Paralysis?

Patient is a 50-year-old-year-old left-handed white male who presents with his wife for evaluation of multiple symptoms that have been present since an MVA in 02/2013. At that time, he was T. boned and his car was totaled. He has amnesia for the event and is unaware whether or not he hit his head. The airbag did deploy. Afterwards, he was confused and noted significant pain in his neck and upper back. Since then, he has had multiple symptoms. He does have involuntary twitching on the right, more than left, both hands, legs, and sometimes feet. He demonstrates one of these twitches and it looks like a focal myoclonic jerk of a limb. These occur on a daily basis. He also has problems with his left thumb and index finger locking up. When he is fatigued, especially when his neck gets tight, he has some problems with word finding, paraphasic errors, and syntax errors. He did see Anthony P. Knox,

Weakness or numbness on one side of the body or in an arm or leg.

Periodic Paralysis Syndrome is a blanket term for a couple of inherited muscular disorders. The most common types are hypokalemic periodic paralysis and hyperkalemic periodic paralysis. Both of these are inherited and generally present from childhood, tho it is possible for symptoms to start showing later in adolescence. In hyperkalemic periodic paralysis, high levels of potassium in the blood interact with genetically caused abnormalities in sodium channels (pores that allow the passage of sodium molecules) in muscle cells, resulting in temporary muscle weakness and, when severe, in temporary paralysis. This disease may be caused by genetic defects in either the calcium channel or the sodium channel. Hypokalemic disease may be caused by genetic defects in either the calcium channel or the sodium channel (Medline Plus).

Neuromyotonia is an extremely unusual disorder, where impulsive motor unit are constantly firing and activating the muscle fibers. Neuromyotonia has several symptoms but the most common ones are muscle pains and twitching. The condition affects the voltage-gated potassium channels, by reducing the number of voltage gated potassium-complex resulting in prolonged depolarization of the motor nerve terminal and excessive acetylcholine release. Treatment depends on the varying symptoms from person to person but usually people are prescribed with medication or undergo a plasma exchange.

Autonomic dysreflexia is a complication of spinal cord injuries. “It is a massive, uncompensated cardiovascular reaction mediated by the sympathetic nervous system” (Lewis, 2014, p.1784). There are many factors that need to be explored in relation to the complication of autonomic dysreflexia in spinal cord injuries. These factors include etiology, pathophysiology, clinical manifestations, diagnostics, and collaborative care.

The following are symptoms according to the American Red Cross Nursing Assistant text book the patient could experience: “Slurring of words, Drooping of the features on one side of the face (for example, the eyelid and the corner of the mouth), trouble seeing in one or both eyes, weakness or numbness in an arm or leg, a sudden, severe headache, dizziness or loss of balance, confusion, or a loss of consciousness, a generally ill appearance, or abnormal behavior” (Page 91). Our text book in chapter 18 calls the weakness hemiparesis and the paralysis is called hemiplegia. These are experienced on one side of the body. F.A.S.T is a great way to check

Unilateral vocal fold paralysis (UVFP) is the complete immobility of one vocal fold. According to Sapienza and Ruddy (2013), “90% of vocal fold paralysis that occurs is unilateral and caused by damage to the peripheral nervous system” (p. 189). Vocal fold paralysis is typically considered a symptom of a disease or neurologic disruption. In one study, it was found that vocal fold paralysis was caused by surgical trauma, tumors or neoplasms, unknown or idiopathic factors, trauma, central nervous system dysfunction, radiation, inflammatory, cardiovascular, and other causes (Chen, Jen, Wang, Lee, & Lin, 2007). Symptoms of unilateral vocal fold paralysis may include: aphonia, abnormal vocal quality (breathy, hoarse, and/or strained), and dysphagia. Onset of UVFP may be life altering as the individual has to find compensatory strategies for voicing or even alternative methods of communication. The individual is also left susceptible to aspiration due to the lack of airway protection. These factors make it critical to diagnose the impairment so as to provide the appropriate treatment.

Hypovolemia can be due to many predisposing factors such as fracture and surgery. The patient experienced a type of open fracture which is categorize by a wound in combination with the fracture (Whiteing, N., 2008, p. 50). Open Reduction Internal Fixation (ORIF) is the most common surgical technique for patients with open fracture which also includes tibia and fibula (William, L & Hopper, P., 2011, p. 1071). Since it was a major surgery massive blood loss or hypovolemia can be experience by a patient who will undergo this procedure. Craft, J., Gordon C., & Tiziani, A. (2011, p. 895) states that hypovolemia is a decrease in extracellular fluid volume and decrease in blood volume. In addition, Buttaro, T., (2013, p. 982) implies that there is approximately two (2)

The muscular system, in conjunction with the skeletal system, is responsible for movement of the body among other things (VanPutte, 270). The ability of the human body to move has been critical in the survival of the species over the years—for example; escaping from predators is only possible with skeletal muscle contraction. Hansen’s disease generally only affects the peripheral nerves of the extremities, not the locations of the larger muscle groups; however the smaller muscles of the hands and feet are vital for the well-being of individuals. For example, it would be quite difficult to feed oneself without the use of hands. Unfortunately, extreme cases of Hansen’s disease cause paralysis of the individual’s hands and feet. Paralysis occurs due to deadening of the peripheral nerves, both sensory and motor. As the afferent neurons lose the ability to receive and send stimuli, the nerve impulses (action potentials) are sent to the central nervous system less and less often. Even so, the action potentials that are transmitted to the CNS still are unlikely to stimulate the skeletal muscles for contraction. This is because the efferent peripheral neurons of the hands and feet are damaged as well. In effect, the sensory nerves of the extremities cannot receive much stimuli, and the motor neurons are also less able to start the action potentials in the skeletal muscle

For the pass this assignment will describe the investigations that are carried out to enable the diagnosis of these physiological disorders. For the merit this assignment will assess possible difficulties involved in the diagnosis from their signs and symptoms.

They may develop alone or in combination, but as the disease progresses, all are usually present. There is no true paralysis. The symptoms are always bilateral but usually involve one side early in the illness. Because the onset is insidious, the beginning of symptoms is difficult to document. Early in the disease, reflex status, sensory status, and mental status usually are normal. Postural abnormalities (flexed, forward leaning), difficulty walking, and weakness develop. Speech may be slurred. Autonomic-neuroendocrine symptoms include inappropriate diaphoresis, orthostatic hypotension, drooling, gastric retention, constipation, and urinary retention. Depression is also prevalent.

The human body contains blood and fluid compounds and elements like chloride, phosphate, potassium, calcium, sodium, and magnesium known as electrolytes that occur naturally to control important physiologic functions. When the body levels of electrolytes are low (hypo) or high (hyper) it results in electrolyte disorder. Depending on the affected electrolyte(s), when body electrolytes are hyper (high) or hypo(low) it leads to electrolyte disorder, which in turn disrupts blood ionized salts balance ( Buttaro, et al., 2017). For instance, disruption of chloride leads to either hyperchloremia or hypochloremia, calcium (hypercalcemia or hypocalcemia ), Potassium (hyperkalemia or hypokalemia), Magnesium disruption

Another common cause for paralysis would be bonds that tie the characters to the city

As a child Browning was struck with Hypokalemic Periodic Paralysis; a disease that causes periods of paralysis which result in long, slow recovery periods. This, in turn, sparked an even greater interest in her battle

Skeletal deformities (spinal kyphosis and bowed legs ) , often compression of vertebrae , shorting patient's trunk