Table 2

Patients with secondary hyperkalaemic paralysis (synopsis of the literature)

ReportAge/sexClinical symtomsPotassium (mmol/l)Creatinine (mmol/l)CSFPossible reason for hyperkalaemiaECG findingsNeurographic and EMG findingsTreatmentOutcome
This case62/MTetraplegia and distal areflexia within one week; distal dysaesthesia; cranial nerves normal8.20.17NormalMild renal failure; spironolactone intakeQRS prolonged T raisedDecreased NCV and amplitudes; F waves increased; EMG normalHaemodialysis; Ca infusionCompletely resolved
Naumann et al4 36/FSymmetric tetraparesis, dysaesthesia and areflexia; cranial nerves normal8.41.47NormalNephrosclerosis; chronic renal failureQRS prolonged; T sharpDecreased NCV; EMG normalHaemodialysisCompletely resolved
Khullar et al6 50/MAscending tetraparesis; anaesthesia in feet7.01.01NdDiabetes; anuriaNdNdHaemodialysisCompletely resolved
Freeman and Fale5 75/MDistal tetraplegia, no areflexia; cranial nerves normal10.20.21NormalDiabetes; amiloride intakeQRS prolongedNdInsulin and glucose infusionCompletely resolved
Tamm3 a: 66/MTetraparesis, tremor11.22.06NdRenal failure; spironolactone intakeQRS prolonged; P absentNdHaemodialysis; Ca infusionCompletely resolved
b: 65/MAscending paraparesis9.31.20NdChronic renal failure; excessive cherry intakeQRS prolonged; P absentNdHaemodialysis; Ca infusionCompletely resolved
c: 73/FTetraplegia8.6NdNdSpironolactone intake; no renal failureNormalNdInsulin and glucose infusion; diuresisCompletely resolved
Rado10 76/FPure motor tetraplegia within one month; cranial nerves normal8.8NdNdSpironolactone intake; chronic renal failureQRS prolonged; P absent; T raisedNdCa and insulin infusion; resoniumCompletely resolved
Shinotoh et al2 38/MTetraplegia and areflexia within one week; distal paraesthesia; cranial nerves normal8.71.26NdTraumatic rupture of urinary bladderQRS prolongedDecreased motor CNV; increased distal latencyHaemodialysis; insulin infusionCompletely resolved
Palmer and Wikström7 68/MPure motor tetraparesis7.90.10NdSpironolactone intake; normal renal functionT raisedNdInsulin and glucose infusionCompletely resolved
Jaffey and Martin11 69/FTetraparesis with hyporeflexia and paraesthesia9.3NdNdSpironolactone intake; mild renal failure“Bizarre” QRS; P absentNdCa and insulin infusionCompletely resolved
Udezue and Harrold8 69/MProgressive ascending pure motor paralysis and areflexia9.3NdNdSpironolactone (100 mg/day)QRS prolonged; P absentNdInsulin and glucose infusion; peritoneal dialysisDied of pulmonary embolism; paralysis resolved
Livingstone and Cumming9 38/MAscending paraparesis and areflexia of the lower limbs; no sensory symptoms; cranial nerves normal9.31.25NdTraumatic urine excretion failure“Typical signs of hyperkaliaemia”NdPeritoneal dialysisCompletely resolved
Gelfand et al14 44/FTetraplegia; mental disorientation9.8NdNdGeophagia (clay); chronic renal failureArrhythmiaNdNdCompletely resolved
Kalbian13 46/MParaparesis of the lower limbs8.0NdNdSpironolactone intake; potassium supplementT raisedNdInsulin and glucose infusionCompletely resolved
Herman and Rado12 43/MTetraplegia and areflexia; pain in all limbs9.50.40NdSpironolactone intake; diabetic nephropathyT raisedNdInsulin and glucose infusionDied because of cardic arrest
Richardson and Sibley16 21/MTetraplegia and areflexia9.9NdNormalGlomerulonephritisT raisedNdInsulin and glucose infusionDied because of “convulsions”
McNaughty and Burchell15 49/FTetraplegia8.611.2NdRenal failure; pyelonephritisP absent; T raisedNdGlucose and Ca infusionCompletely resolved

  • m=Male, f=female, nd=no data available, NCV=nerve conduction velocity, EMG=electromyogram, Ca=Calcium.