Glucocorticoid-induced Thyrotoxic Periodic Paralysis Following Lumbar Nerve Root Block

Thyrotoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism characterized by hypokalemia and acute muscle weakness. One patient developed progressive lower limb weakness hours after receiving a lumbar nerve root block with a glucocorticoid injection, which worsened to the point where he had difficulty walking. Laboratory tests confirmed hypokalemia and hyperthyroidism. Symptoms were resolved with intravenous potassium, and the patient was subsequently diagnosed with TPP triggered by glucocorticoid injection. Although TPP is typically triggered by high-carbohydrate intake, exertion, or alcohol consumption, glucocorticoid-induced TPP is rare. Clinicians should be aware of these potential triggers in patients with hyperthyroidism.