Common Specialities
{{speciality.keyWord}}
Common Issues
{{issue.keyWord}}
Common Treatments
{{treatment.keyWord}}

Hyperkalemic Periodic Paralysis Questions

My father (age 56 years & weight 70 Kg) has been diagnosed with Non-Small Cell Lung Cancer, Stage 4 with primary tumour in his Left Upper Lobe and metastasis in Liver and Bone. The biopsy report has confirmed it to be adenocarcinoma. The cancer was detected while he was admitted at a hospital in Mumbai and was undergoing treatment for Acute Paraplegia which happened on 02 Nov 16, due to arteries-Venous Fistula at D-10 level resulting in oedema/ ischemia of the spine from D-5 to Conus. After two failed attempts of embolization, towards treatment of the AVF, surgical clipping of the fistula was undertaken on 10 Nov 16. As part of post-operative rehabilitation therapy for his paraplegia, he was given 65 session of Hyper-basic Oxygen Therapy at 2.4 ata pressure for about two and a half month and about two hour of Physiotherapy for the same duration. My father was recovering well and had started walking with the help of support (walker). MRI of the spine taken in mid Jan & Mid June 2017 indicates that the spinal cord oedema had improved significantly, although atrophy of the spine cord is still present. He complained of wheezing and breathing difficulty and towards ascertaining the cause a X-ray was taken on 23 Feb 17 which showed massive pleural effusion in his left lungs. A series of tests followed with the ultimate result as NSCLC Stage 3B. It was categorised as Stage 3B as the pleural effusion was para-malignant and no metastases was noted in any other body parts. He was started with CCRT treatment which concluded on 05 May 17. During the treatment he was given daily dose of radiation therapy to his primary tumour site in his left upper lobe using IGRT (60 Gy/ 30 #/6 weeks) and weekly chemotherapy with paclitaxel (150 mg) & Carboplatin (300 mg) for 6 weeks. Despite the treatment, the cancer is advancing and has now spread to Liver and Bones as brought out in his latest PET CT report. Lung tissue which was obtained during CT guided biopsy conducted in the month of Mar 17, before the CCRT treatment was started, has tested positive for EGFR mutation – “E746_A750del is detected in EXON 19 of EGFR gene”. His doctor has started my father on Erlotinib 150 mg OD since 26 Jun 17. My father has developed Post Obstructive Pneumonia in his left lung and there is consolidation in his entire left lung. This is evident from a recent X-ray. He is having difficulty in breathing, takes short & fast breath, sweats a lot, feels cold, has irritation in his throat and gets tired very fast. He also has issue eating solid food and had greatly cut down his diet. He was started on Oral antibiotic for a week, but did not respond to it. He is admitted in the hospital and is being injected with antibiotics through IVs and injections. His condition remains to be same with no much improvement. His SPO2 level is also low at 90-92%. My father also has severe lower back pain and has also been diagnosed with progressive paraparesis. Because of the back pain he is not able to lie down on his back. A recent screening of the entire spine has confirmed that there is no evident compression of the spinal cord but clearly shows a number of metastasis in the vertebrae (Clivus, Dv2, Lv2, Lv4 & Tail Bone). There are plans to start him on Radiation Therapy for his spine. Is this:- 1.The right therapy for him? 2.What other option do we have for treating his spinal mets? 3.Can Radiation to treat his mets in the vertebra, damage his spine and cause further paraparesis? 4.Could you please suggest anything towards treatment of my father?

DM - Oncology, MD - Internal Medicine
Oncologist, Noida
If there is localized backache than radiation treatment may be the right choice for the time being. Though it won't cure lung cancer. It may help in resolving the local pain. Patient is on erlotinib since 26-6-17. The medicine should have shown some benefit by now. Continue it for another one month. It may be stopped for the time /days spinal radiation is given by your treating doctor. Add bisphosphonates taking care of creatinine and calcium levels. Ask for appropriate amount of analgesics. Given the history of spinal cord atrophy, yes there is risk of further damage to spinal cord by radiation. The dose, fractionation and the areas not to be irradiated will be decided by treating radiation oncologist. For EGFR mutant erlotinib is one of the best drugs. Take care of nutrition. It's important.
5 people found this helpful
Submit FeedbackFeedback

My father has been diagnosed with Non-Small Cell Lung Cancer, Stage 4 with primary tumour in his Left Upper Lung and metastasis in Liver and Bone. The biopsy report has confirmed it to be adenocarcinoma. The cancer was detected while he was admitted at a hospital in Mumbai and was undergoing treatment for Acute Paraplegia which happened on 02 Nov 16, due to arteries-Venous Fistula at D-10 level resulting in oedema/ ischemia of the spine from D-5 to Conus. After two failed attempts of embolization, towards treatment of the AVF, surgical clipping of the fistula was undertaken on 10 Nov 16. As part of post-operative rehabilitation therapy for his paraplegia, he was given 65 session of Hyper-basic Oxygen Therapy at 2.4 ata pressure for about two and a half month and about two hour of Physiotherapy for the same duration. My father was recovering well and had started walking with the help of support (walker). MRI of the spine taken in mid Jan & Mid June 2017 indicates that the spinal cord oedema had improved significantly, although atrophy of the spine cord is still present. He complained of wheezing and breathing difficulty and towards ascertaining the cause a X-ray was taken on 23 Feb 17 which showed massive pleural effusion in his left lungs. A series of tests followed with the ultimate result as NSCLC Stage 3B. He was started with CCRT treatment which concluded on 05 May 17. During the treatment he was given daily dose of radiation therapy using IGRT (60 Gy/ 30 #/6 weeks) and weekly chemotherapy with paclitaxel (150 mg) & Carboplatin (300 mg) for 6 weeks. Despite the treatment, the cancer is advancing and has now spread to Liver and Bones as brought out in his latest PET CT report. Lung tissue which was obtained during CT guided biopsy conducted in the month of Mar 17, before the CCRT treatment was started, has tested positive for EGFR mutation – “E746_A750del is detected in EXON 19 of EGFR gene”. The medicine oncologist has however said that the gene profiling of the primary tumour tissue is not sufficient for starting Targeted Therapy and gene profiling of a tissue obtained from any of the metastatic site is necessary for the same. Three procedures have been undertaken to obtain tissue sample from the metastases site, twice from the liver and once from the pleural deposits, and all the three times the cancerous tissue could not be obtained. Due to non-availability of conformed cancerous tissue from the metastases site, a firm treatment plan has yet not been made for my father. In the meantime, the doctor has recently started my father on Erlotinib 150 mg OD as there has been considerable delay in his next phase of treatment due to non availability of metastases cancerous tissue. Could you please help me by answering the following:- 1.Can you suggest anything towards treatment of my father? 2.Is gene profiling of tissue from a metastases site absolutely necessary for starting targeted therapy for my father? 3.I read online that Erlotinib or Afatinib can be used as Targeted Therapy for patient with EGFR Lung cancer mutation. Is this true? If yes, will a daily tablet of these drugs be sufficient for his next phase of treatment, or a concurrent conventional chemotherapy is also required? 4.Can 65 session of Hyper-basic Oxygen Therapy at 2.4 ata given at a stretch of about 80 days, with a daily dose of 02 hour be a cause of his cancer? I have read it online that the oxygen free radical produced during HBOT treatment can cause cancer.

Dr. Dharma Ram Poonia 86% (36 ratings)
MS, DNB (Surgical Oncology)
Oncologist, Jodhpur
Hi lybrate-user, You summarize the case very well. I understanding of your case says, he has Ca lung adenoca, treated with dCTRT, that progressed and now disseminated disease, which is not curable by any means. The goal of the treatment in such cases would be palliative only, which means to increase longevity without causing much side effects of the drugs and reduce his problem. Now going towards your questions, 1&2. At this juncture, Gene profiling is not necessary for me but to start the EGFR targeted medicines, which includes Erlotinib/Gefitinib or Afatinib. Usually patients with such mutation as in your case responded but unfortunately not for the indefinite period but averagely 6 to 10 months. On progression, you have to get the gene profiling to see the change in the mutational status. You can refer to NCCN guidelines or American cancer society information. 3. Your father should receive, targertd therapy only, no chemotherapy for sure. It is proven better than chemotherapy in terms of Quality of life and progression free survival (average duration to progress on Treatment) 4. Regarding etiology or causation of lung cancer, HBOT not implicated for such cancers. And more so any carcinogen if cause cancer, it has a reasonable time to show its effects, like you must have seen chronic (long term) smokers will develop lung cancer. HBOT cause local hypervascularization and produce free radicles, so many studies tried see its role as a carcinogen, but tilll date it is not proven carcinogen as per ICAR. Hoping it solves your query. It is nice to see a son is keen and read in-depth about his father's illness. Good luck for further treatment.
2 people found this helpful
Submit FeedbackFeedback

I am suffering from restless leg syndrome and hypertension and sleep paralysis for rls I am taking pramipex 2.5 and tazloc am for BP but what medicine should I take for sleep paralysis.

Dr. Sajeev Kumar 89% (38877 ratings)
C.S.C, D.C.H, M.B.B.S
General Physician, Alappuzha
Sleep paralysis can sometimes be a symptom of another sleep disorder called narcolepsy, which causes severe daytime sleepiness and an inability to stay alert for more than a few hours. Although there's no cure for narcolepsy, the condition can usually be managed with appropriate medication.
2 people found this helpful
Submit FeedbackFeedback

I had a attack of paraplegia in 2011. After 5 year im still unable to walk properly. There is little bit problem in walking but it doesn't meant I can not walk, I can walk but not so properly. So I want to start gym. Can I go to gym? Is it beneficial for me? If I go to gym then what type of precautions should I take.

Dr. Pratibha Jain 92% (269 ratings)
Bachelor of Ayurveda, Medicine and Surgery (BAMS)
Ayurveda, Delhi
I had a attack of paraplegia in 2011. After 5 year im still unable to walk properly. There is little bit problem in w...
That will be good for you but in expert observation. Use mahanarayan oil for massage and take steam with dashmool, give you better result. For more medical advice consult with me online on Lybrate.
Submit FeedbackFeedback

Is Sleep Paralysis a Symptom of a Serious Problem? Yesterday left side full not sense (top to bottom like head, hand and leg) this is 1st time happening to me.

Dr. Siddharth Kharkar 88% (93 ratings)
MBBS, MHS, MD - Neurology (USA), Fellowship In Epilepsy, Clinical Attachment In Movement Disorders
Neurologist, Mumbai
Usually sleep paralysis affects the entire body and is part of narcolepsy which includes cataplexy (neck quickly losing power e.f. While Laughing) and excessive daytime sleepiness. Since your episode was so asymmetric you should be very intensively evaluated to rule out a transient loss of blood supply to one part of your brain (a transient ischaemic attack or TIA)
1 person found this helpful
Submit FeedbackFeedback

My grandmother got blood clot in brain and now she is suffering from paralysis her left leg and hand are not working she even lost her talking ability. She is 82 years old and doctors saying that they can not do anything to help her. But she is able understand what we are saying to her and her right side area is working she says through sign that she is hungry and thirst. But she is not able to open her eyes please someone help us with your answers ASAP please I am begging you on my knees. I can not bear to see her like that she was going through hell.

Dr. N.K. Khetarpaul 90% (141 ratings)
MD - General Medicine
General Physician, Hisar
Dear lybrate-user, how I wish our science had something to help your grandma. When blood clots in an artery or pipe, the area where blood goes becomes blood less and that area becomes dead. Now small portion of her brain has died due to no blood supply. The blood supply to that area could have been corected by clot bursting drugs within 1-3 hours of attack of paralysis but not later. Under present circumstances our science has no treatment to replace dead portion of brain. Just serve her with tender care, accept it as her destiny and your destiny to watch this helplessly. We (our science) are very weak in treating neurological disorders. Let us hope future brings some hope with transplantation of brain tissue!
1 person found this helpful
Submit FeedbackFeedback

I am suffering from paralysis and the paralysis attack to my right side and damage my leg, hand and mouth.

Dr. P Nagaraj 89% (3802 ratings)
FRHS, Ph.D Neuro , MPT - Neurology Physiotherapy, D.Sp.Med, DPHM (Health Management ), BPTh/BPT
Physiotherapist, Chennai
Do take rehabilitation exercises with gait training from neuro physiotherapist along with medications from neuro physican best wishes.
2 people found this helpful
Submit FeedbackFeedback

We have a cellular tower on top of our house past 7 years. We dint notice a huge problem in our health but recently my mother who is always at home had a paralysis attack. And I experienced headaches, sleep disorders recently, so now is it a big problem? The contract will end in 2 years. We should shift our family? Or we can manage these 2 years with some precautions? Please help me.

MBBS
General Physician,
We have a cellular tower on top of our house past 7 years. We dint notice a huge problem in our health but recently m...
This may be due to cosmic radiation by the tower therby may be causing the numerous health hazards one should avoid the exposure to the tower as far as possible preferably if the tower can be shifted. Consult a doctor near your locality. For future health hazards.
2 people found this helpful
Icon

Book appointment with top doctors for Hyperkalemic Periodic Paralysis treatment

View fees, clinic timings and reviews