Hello, The thyrotoxic periodic paralysis is related to sudden shift of potassium ion into the cells and causing hypokalemia with secondary features. Many of the times, there are no associated symptoms of hyperthyroidism, which makes the issue more worse without diagnostic suspicious. Following are usual associated with Thyrotoxic periodic paralysis as: - Adult male with no family history of periodic paralysis - High pulse rate - Elevated systolic blood pressure on repeated readings - Wide QRS complexes on EKG - First degree A-V block in many of the cases - Low amplitude of electro-myographic reading of the muscle with subsequent changes after epinephrine injection The cause of thyrotoxicosis is usually auto immune in majority of the instances and can be well controlled with the anti thyroid medications. The thyrotoxic periodic paralysis is managed with primary potassium level correction with potassium chloride solution or tablets and later it resolve completely after the control of thyrotoxicosis. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon