A 35-year-old woman presented with myalgias and progressive loss of strength of the four limbs, predominantly proximal with a 24-hour history of cephaloparesis.
Schizophrenia under treatment with monthly pipotia i/m and haloperidol 5 mg/day stood out among its antecedents.
A year ago, she had experienced an episode similar to the current one, with loss of strength of the four limbs, self-limited, which reverted without treatment.
On admission, the patient had good general condition, apnea, adequate hydration and TA of 110/70 mmHg.
Neuromuscular evaluation revealed generalized hypotonia, quadriparesis with difficulty walking and cephaloparesis.
Osteotendinous reflexes were globally decreased and sensitivity was preserved.
On admission, he presented K+pl of 1.3 mEq/L, metabolic alkalosis and elevated CK.
Hydroelectrolytic replacement was initiated with rapid improvement of muscle strength and normalization of K+pl and CK levels.
As in the previous case, high potassium levels and concomitant alteration of acid-base balance guided the renal origin of electrolyte disturbances.
