Periodic Paralysis: Secondary Causes???

Periodic Paralysis: Secondary Causes???

I was asked the question, “Can Periodic Paralysis (PP) be caused by other or secondary causes such as vitamin deficiency, vaccinations or toxic exposure or is there always a genetic or inherited cause?”

My answer is:

For those of us with the varying forms of Periodic Paralysis (a mineral metabolic disorder, also known as an ion channelopathy,) the cause is almost entirely/exclusively genetically related. Secondary causes, in my mind, do not exist but others believe they do. I believe that those people actually have/had the genetic mutation but nothing introduced in their life set it into motion until the vaccination, illness, toxic exposure or more that they believe caused it. Those things are/were triggers that set symptoms/paralysis into motion, but the predisposition, a genetic mutation, was already there (inherited, we are born with it). As far as I know, there is no proof that there are secondary causes for PP. There are definite genetic mutations related to the known forms of PP. There are several other medical conditions called 'differential diagnoses' that have similar symptoms like Sjogren's, Bartter Syndrome, Conn Syndrome, Multiple Sclerosis, Hyperaldosteronism and these must be ruled out before a diagnosis is confirmed. 

Periodic Paralysis is far too rare to just happen due to exposure to something. My other thought is that it really is not Periodic Paralysis unless it is genetic, although only 50% of the mutations have been found and may never be found in this lifetime. Symptoms may be similar but it is not PP unless there is a genetic component, whether it has been found or not. So in my belief, due to my research, PP is not secondary to anything. There are many triggers, however, that may set a predisposed PP into motion. Vaccination, illness, toxic exposure, drugs of all kinds, infectious diseases, IV's, anesthesia, steroids and so much more may be the initial trigger for the first episode/s and symptoms, but they are not the cause....not for true Periodic Paralysis...The only cause of Periodic Paralysis is a genetic mutation (whether it has been found or not).

 Criteria For Making A Genetic Diagnosis:

The following are the typical genetic mutations for most of the known forms of PP:

Hypokalemic Periodic Paralysis is caused by abnormalities in the SCN4A, KCNJ18 and CACNA1S genes.

Hyperkalemic Periodic Paralysis is caused by abnormalities in the SCN4A gene.

Andersen-Tawil Syndrome is caused by abnormalities in the KCNJ2 gene and the KCNJ5 gene.

Normokalemic Periodic Paralysis is caused by abnormalities in the SCN4A and CACNA1C genes.

Paramyotonia Congenita is caused by abnormalities in the SCN4A gene.

Thyrotoxic Periodic Paralysis is caused by abnormalities in the KCNE3, KCNJ18, SCN4A  and CACNA1S genes. (most cases are not linked to these genetic mutations...most are from malfunctioning thyroids)

S= sodium channelopathy
K= potassium channelopathy
C= calcium channelopathy

If genetic testing that is totally unbiased and unlimited is negative for PP, it only means that the person has a form has not yet been discovered or recognized. It does not mean that they do not have PP.


Until later.....

Added June 24, 2024:

Three newer discovered genetic mutations for Periodic Paralysis!!!

ATP1A2 mutation,

MCM3AP mutation

RYR1 mutation