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Persisting fatigue & myalgia as the presenting features in a case of hypokalaemic periodic paralysis


Senior Member
He was managed for symptoms of persistent fatigue with referral for further assessment and
investigation in the local chronic fatigue syndrome clinic.

It can be interesting to hear about cases of people misdiagnosed with CFS.


BMJ Case Reports 2017; doi:10.1136/bcr-2017-219991
  • Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
Persisting fatigue and myalgia as the presenting features in a case of hypokalaemic periodic paralysis
  1. Matthew Thomas Neame1,
  2. David Wright2,
  3. Surendran Chandrasekaran2
+Author Affiliations

  1. surendran.chandrasekaran@nhs.net
  • Accepted 15 June 2017
  • Published 10 August 2017
We report a case of a 9-year-old boy who developed hypokalaemic periodic paralysis (HypoPP) following a prodrome of persistent fatigue and muscle aches associated with mildly elevated creatine kinase (CK) levels.

HypoPP is usually associated with a sudden onset of weakness and hypokalaemia at presentation. A review of published cases failed to identify any other reports of individuals with a similar onset of symptoms and elevated CK levels prior to the development of frank HypoPP.

In the case described above, the association of these symptoms with elevated levels of CK may have been related to the underlying mutation in the skeletal muscle calcium channels that was subsequently identified.

In cases of persisting fatigue and myalgia associated with elevated CK levels it may be helpful to consider HypoPP in the differential diagnosis.

Jenny TipsforME

Senior Member
I have all these symptoms and have had raised creatine kinase on a bad myalgia day (returned to normal ie 10x reduced on non achy day but fobbed off due to fluctuation). My Period Paralysis testing was inconclusive though - borderline results but severe symptoms so they didn’t think the test results were a good explanation.

There’s a long thread on here about my paralysis issues https://forums.phoenixrising.me/threads/temporary-paralysis-i-need-your-insights.44812/