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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for hypokalemic periodic paralysis while on Valium

Answered by
Dr.
Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2263 Questions

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Posted on Tue, 23 Aug 2016 in Brain and Spine
Question: My sister (age 59) has been to 4 emergency rooms in the last 2 weeks. She is currently on no medications. She is having attacks that leave her unable to move her body. She is able to understand questions but can't answer. She describes herself as a Zombie. They last for around 1 hour. The Doctors have ruled out stroke, MS, heart, and she waiting work on a test for Lymes Diesease. None of the 4 ERs found anything and the University of Tennessee Medical Center admitted her for 4 days and released her after finding nothing. They observed and videoed one of the episodes. She was hooked up to a machine that ruled out a seizure. The morning after being released from UT hospital, she had another attach and drove 3 1/2 hour to Vanderbilt hoping to get admitted there. She is desperate for answers. The heart rate is the first sign - has gone as high as 125. The symptoms are changing also. Now she can communicate during the episodes but her body parts are moving in an unconnected way. She visited a Neurologist Thursday and he told her he had not seen anything like this in his 25 years of practice. We are hoping that one of your 25 Neurologist can connect some dots. She's been prescribed Valium and rest for a month and then get in Vanderbilt. Thanks for your help!
doctor
Answered by Dr. Neeraj Kumar 3 hours later
Brief Answer:
Please get investigated as advised

Detailed Answer:
Hello,
I have gone through your question and understand your concerns.

The symptoms described may be cataplexy, hypokalemic periodic paralysis or psychogenic.
Complex partial seizure of medial temporal region can be having such episodes too with difficult pick up rate on EEG.

She needs to get MRI brain, blood investigation especially serum potassium.
Video recording of episodes may be helpful for analysis and diagnosis (which you've already mentioned).

Proper sleep, avoid late night awakening.

Anti epileptic may be tried if evidence available on video.
Psychiatric consultation will be required if all investigations are normal.
Please provide reports and prescription of previous consultation.

Hope you found the answer helpful.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Neeraj Kumar 1 hour later
Since my question, my sister text me this list of test that have been run: MRI, CT scan with and without contrast, EKG, echo cardio XXXXXXX thyroid test, calcium score test, and all been negative. Does that list narrow the possibilities?
doctor
Answered by Dr. Neeraj Kumar 10 hours later
Brief Answer:
Get neurologist and psychiatrist consultation

Detailed Answer:
Hello,
If brain imaging and blood reports are normal along with eeg then she needs to be evaluated by a neurologist.
Potassium testing may be done along with serum protein and albumin.
Psychiatric consultation may be required if all assessment and investigations are normal.
Regards
Dr N Kumar
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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