499P Exploring the impact of diet and physical activity on episodic muscle weakness and paralysis in hypokalemic periodic paralysis: a qualitative interview study

• Published in: Neuromuscular disorders : NMD 2024-10, Vol.43, p.104441, Article 104441.632
• Main Authors: Welland, N., Hagen Venås, B., Ellefsen-Martinsen, M., Ludt Fossmo, H., Dybesland Rosenberger, A., Dahl, H., Ørstavik, K., Nordstrøm, M.
• Format: Article
• Language: English
• ISSN: 0960-8966
• DOI: 10.1016/j.nmd.2024.07.641

Primary hypokalemic periodic paralysis (HypoPP) is a rare genetic neuromuscular disorder characterized by episodic attacks of skeletal muscle weakness or paralysis with spontaneous recovery. Attacks often occur with concomitant hypokalemia and can last from minutes to hours. The episodic attacks are frequently triggered by specific factors, and case series have identified lifestyle factors, such as dietary intake and physical activity (PA), to be associated with them. However, there is limited knowledge regarding the extent to which these factors are important. In this study, we aimed to explore patients' experiences with dietary intake and PA through semi-structured interviews. The research questions were a) which dietary factors and PAs are experienced as triggers of periodic muscle weakness or paralysis? and b) what strategies are used in relation to their dietary intake and PA to prevent or manage periodic muscle weakness or paralysis? The study included 14 participants aged 21-58 years with genetically verified HypoPP. The interviews were transcribed and analysed using systematic text condensation, resulting in 6 preliminary main themes: 1. A combination of trigger factors increase vulnerability to attacks 2. Regular PA, a healthy diet, and a warm and stable ambient temperature can prevent and protect against attacks 3. Gradually increased tolerance for physical activity 4. Warm-up/cool down important to prevent attacks 5. Variable use and uncertain dose-dependent response from potassium supplements 6. Need for diagnosis-specific lifestyle advice. The participants experience that regular moderate PA and a diet consisting of complex carbohydrates, limited ultra-processed foods and moderate sized meals makes them less vulnerable to their triggers. A combination of trigger factors such as stress, variable or cold ambient temperature, diet, inactivity, and strenuous PA can increase susceptibility to episodic muscle attacks.