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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29520
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have used you many times to my satifaction, my son is 35,

Customer Question

I have used you many times to my satifaction, my son is 35, & has started to suffer from paralysis, one day he is good, then his legs hurt, & he can hardly walk, they have said he is suffering from periodic paralysis, they have put him on high doses of Potassion, he is getting worse, it goes into his arms,now his lower back. they ruled out ms- & other diseases, they feel that they have dianosed him correctly, but he is steady getting worse.   Please help. I want a doctor, not a pa to address this question..    awaiting your answer.
Submitted: 5 years ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 5 years ago.

Greetings.

 

Can you please tell me about his investigations done? What did his nerve conduction study, muscle biopsy and potassium levels show? How long ago he was diagnosed as periodic paralysis?

 

Dr. Arun

Customer: replied 5 years ago.
You have ask me a question that I can not answer, I was there when they did the nerve conduction test, & checked his blood level, that is how they assumed that he had this disease, for a while, they have been having him take a extra Potassion pill when he feel this coming on, it is not helping much now, please my spelling I am so scared.
Expert:  Dr. Arun Phophalia replied 5 years ago.

Hello,

 

The investigations I had mentioned, like neurophysiological studies, muscle biopsy, blood potassium levels during the attack do give the diagnosis almost certainly. Since MS has been ruled out, the other conditions which can mimic the clinical manifestations like chronic inflammatory demylinating polyradiculoneuropathy, hereditary sensory and motor neuropathies, thyroid function abnormalities, myasthenia gravis, Conn syndrome, hyperaldosteronism, should also be ruled out.

 

The periodic paralysis has usually three-four different varieties of presentation. One of them do have fixed muscle weakness. This muscle weakness usually do not increase after a certain duration. Another variety called as Hypokalemic periodic paralysis, if untreated, fixed proximal weakness is experienced, which may interfere with activities. But in this also, after the treatment is initiated, the muscle weakness does not progress.

 

I can understand your concerns as a mother. Any progressing muscle weakness has to be addressed and the diagnosis should be revisited. The other diagnosis, I had mentioned above should be looked for and should be ruled out or ruled in. A neurologist and an endocrinologist should work in tandem to get the best care.

 

Hope this helps.

 

Please feel free for your follow up questions.

 

Dr. Arun

Customer: replied 5 years ago.
Dr arun, I appreciate the way you aswered the questiom.   Cam this porgres into something so that he no has qiaity of life, he is very depressed. I worrie about him takig his lfe. He has alwayes ben Number one in sports. His little girl has done some movies in in LA, but they can't go back out ther because of his conditionl. Please guide me, as I said he is going back to the Mayo clinic on Monday, tell me what to ask for I am so scared. please help.   Thank you so much your knowledge appears great.
Expert:  Dr. Arun Phophalia replied 5 years ago.

Hello,

 

The fixed muscle weakness, if happens, do not progress and it is rare to get so much weakness that there are difficulties in activities of daily living. So quality of the life is more or less preserved but competitive sporting event participation may not be possible. At mayo clinic you need to ask about the other differential diagnosis, investigations needed and if it is periodic paralysis what is the type.

 

It is pleasure assisting you.

 

Dr. Arun

Customer: replied 5 years ago.
Dr Arun Phophalia, I left a reply, I asked if you thought this could be any other disease?, We go back to Mayo Clinic Monday, What are some questions we should ask, you appear to have knowledge of this disease, is there a medication that would help? please give me some questions that I may address to the doctor. He is a very say little Man at this time, & I am so scared, as you can tell. I thank you for your time, If I don't get right back to you, I have to go somewhere, or something else is going on that I have to take care of at the time. Sincerely XXXXX XXXXX
Expert:  Dr. Arun Phophalia replied 5 years ago.

Hello,

 

As we discussed, adrenal problems (hyperaldosteronism and Conn syndrome) are to be investigated and should be ruled out. Other possibilities for these clinical manifestation are Myasthenia Gravis, and various neuropathies. The thyroid abnormalities too should be investigated by getting the thyroid function test, thyroglobulin, free T3, free T4 etc.

 

At this point of time, potassium supplementation is justified. The other medication can only be determined by the further investigations. Choosing Mayo clinic for his further care, is a very good decision.

 

As I mentioned in my previous post also (the second one), you need to ask the examining doctor about the examination clues, clinical findings, further investigative protocol, for this. If he is diagnosed as periodic paralysis, what type it is, as the prognosis is dependent on the type.

 

Hope this helps.

 

Dr. Arun

Customer: replied 5 years ago.
My Dear Doctor Phophalia,   we never finished out conversation, what do you think is going on with my son, could it be MS, I am very scared. I need you to reply, when I don't get right back to you I have gone to bed. or had to run a erron. I thank you so much.
Expert:  Dr. Arun Phophalia replied 5 years ago.

Hello,

 

I can understand your concerns for your son. You mentioned initially that MS has been ruled out. The neurologist must have reason for saying that. They must have done evoked potential tests and spinal tap, apart from MRI, to rule this out. Still the signs and symptoms of MS are quite different than periodic paralysis, so clinically also, one can determine the possibility. With your description, it does not look MS with the episodic symptoms.

 

You are welcome.

 

Dr. Arun

Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 29520
Experience: MBBS, MS (General Surgery), Fellowship in Sports Medicine
Dr. Arun Phophalia and 6 other Health Specialists are ready to help you
Customer: replied 5 years ago.
Dr Phophalia,   I thank you so much, you are wonderful, thank you also for trying to read my typing. I hope & pray if I ever need help again you are there for me, after all you have learned to read my typing. Love & God Bless.
Expert:  Dr. Arun Phophalia replied 5 years ago.

You are welcome.

 

Best wishes and kindest regards.

 

Dr. Arun

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