Thyrotoxic Periodic Paralysis (TPP) is a neuroendocrine emergency and although rare should be part of the differential diagnosis of weakness in a patient presenting with hyperthyroidism. It is usually triggered by high carbohydrate diet, trauma, exposure to cold or strenuous exercise. Most of the cases occur in 20 – 30 year-old Asian males. Diagnosis is clinical with the triad of flaccid paralysis, signs of thyrotoxicosis and hypokalemia. Treatment consist on electrolyte repletion, thionamides and beta blockers. The importance of recognizing the association between hyperthyroidism and hypokalemic paralysis is vital as with successful treatment of hyperthyroidism paralysis resolves.

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