Periodic Paralyses Differential Diagnoses

Updated: Apr 30, 2018
  • Author: Naganand Sripathi, MD; Chief Editor: Nicholas Lorenzo, MD, CPE, MHCM, FAAPL  more...
  • Print
DDx

Diagnostic Considerations

Table 3. Differential Diagnosis of Secondary Periodic Paralyses (Open Table in a new window)

Hypokalemic

Hyperkalemic

Urinary potassium-wasting syndromes

  • Hyperaldosteronism

  • Conn syndrome

  • Bartter syndrome

  • Licorice intoxication

 

Alcohol

Addison disease

Chronic renal failure

Hyporeninemic

Hypoaldosteronism

Drugs - Amphotericin B, barium

Ileostomy with tight stoma

Renal tubular acidosis

Potassium load

GI potassium-wasting syndromes

  • Laxative abuse

  • Severe diarrhea

Potassium-sparing diuretics

Table 4. Differential Diagnosis of Other Entities Causing Acute Generalized Weakness (Open Table in a new window)

Disorder

Pattern and

Distribution of

Weakness

Transient ischemic attacks

Follow CNS distribution (ie, hemiparetic)

May have sensory symptoms and signs

Sleep attacks

Occur at onset or termination of sleep

Last only minutes

Myelopathy

  • Traumatic

  • Transverse myelitis

  • Ischemic

Sensory symptoms

Presence of a sensory level

Sphincter involvement

Myasthenia gravis

Lambert-Eaton myasthenic syndrome

Subacute in onset

Associated autonomic symptoms in LEMS

Hyporeflexia in LEMS

Abnormal repetitive nerve stimulation

Presence of distinct antibodies

Peripheral neuropathy of acute onset

  • Acute inflammatory

  • demyelinating poly-radiculoneuropathy

  • Porphyria

Pattern of weakness

Absent stretch reflexes

Toxins

  • Ciguatera

  • Tetrodotoxin

Clinical presentation

 

Differential Diagnoses