Management considerations in hypokalemic periodic paralysis include accurate 
diagnosis, potassium dosage for acute attacks, choice of diuretic for 
prophylaxis, identification of triggers, creating a safe physical environment, 
peri-operative measures, and issues in pregnancy. A positive genetic test in the 
context of symptoms is the gold standard for diagnosis. Potassium chloride is 
the favored potassium salt given at 0.5-1.0 mEq/kg for acute attacks. The oral 
route is favored, but if necessary, a mannitol solvent can be used for 
intravenous administration. Avoidance of or potassium prophylaxis for common 
triggers, such as rest after exercise, high carbohydrate meals, and sodium, can 
prevent attacks. Chronically, acetazolamide, dichlorphenamide, or 
potassium-sparing diuretics decrease attack frequency and severity but are of 
little value acutely. Potassium, water, and a telephone should always be at a 
patient's bedside, regardless of the presence of weakness. Perioperatively, the 
patient's clinical status should be checked frequently. Firm data on the 
management of periodic paralysis during pregnancy is lacking. Patient support 
can be found at http://www.periodicparalysis.org.