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O. J. S. Buruma, MD, PhD; J. J. Schipperheyn, MD
Department of Neurology University Hospital State University Leyden The Netherlands

Arch Neurol. 1981;38(5):326.

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To the Editor—

Bennet and Forman, in their recent report of a case of chronic toluene exposure that had caused tubular dysfunction, loss of potassium, and muscle weakness (ARCHIVES 1980;37:673), used the term "hypokalemic periodic paralysis" to describe the disease. We believe that this name should be reserved for a disease characterized by attacks of skeletal muscle weakness of varying duration and severity accompanied by a cell-inward shift of potassium ions and not by an increased renal potassium loss. The attacks are provoked by rest after exercise and by high intake of carbohydrates. The disease is usually autosomal-dominantly inherited, although sporadic cases may occur. The hypokalemia is not the cause of the paralysis in this disease. The primary disorder seems to be metabolic, involving the uptake of glucose and the deposition of glycogen in the affected muscle cells. The paralytic attacks are caused by temporary disturbances of sodium conductance, leading . . . [Full Text PDF of this Article]

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