Men with hyperthyroidism often have “periodic paralysis”. How is it treated? Symptoms There are often prodromal symptoms before the attack, such as muscle stiffness, fatigue, abnormal limb perception, drowsiness, headache, or excitement, nervousness, anxiety, and thirst the day before the attack. In older children, the onset and severity of the attack is usually predictable. Paralysis often begins in the proximal muscles of the extremities, with weakness in both lower extremities being the most common first symptom, and may extend to the distal extremities. The extent of paralysis varies from a few muscle groups to the whole body. In mild cases, there is only generalized weakness and walking is still possible; in severe cases, all skeletal muscles of the body are involved, except for the facial muscles, eye muscles, muscles related to articulation and speech, diaphragm, and sphincter muscles. The degree of paralysis can be complete or incomplete. If the paralysis is widespread, it can sometimes lead to respiratory impairment, enlargement of the heart borders or heart failure. During the attack, tendon reflexes are diminished or lost, sensation is normal, and there is no change in perception or consciousness. The duration of each attack may be as short as 1 to 3 hours or as long as 6 to 24 hours, with individual cases lasting up to about 1 week. Hyperthyroid periodic paralysis is autosomal dominant with incomplete episodes. A family history is apparent, but disseminated cases have been reported. It is reported that 88% of cases have their first onset at the age of 7-21 years, and Beijing Children’s Hospital has seen a case in a child with onset at the age of 4 years, which is consistent with foreign reports. It is more common in boys. The interictal period is mostly asymptomatic and without myasthenia gravis. The interval may vary from a few days to several years. The time of onset of paralysis is variable, but it is more common during sleep and rest. Over-eating carbohydrates, exposure to cold, stress, trauma, infection and menstruation are all triggering factors. Local flaccid paralysis can sometimes be triggered by immersion of the limb in cold water. The limb can be gradually relieved after the subsequent invasion of warm water. The diagnosis is based on 1. The medical history provides episodes of skeletal muscle flaccid paralysis without sensory impairment. 2.Serum potassium is less than 3.5 mmol/L at the time of the attack; potassium treatment is effective; 3.Exclusion of other diseases causing secondary hypokalemic paralysis. Treatment: 1. Potassium supplementation, oral potassium chloride solution or extended-release tablets. 2. Active treatment of hyperthyroidism, antithyroid drugs (methimazole, propylthioxypyrimethamine, etc.), iodine-131 treatment, a few need surgery.