A Rare Case of Thyrotoxic Periodic Paralysis Presenting to the Medical ExaminerThompson, Matthew P. DO, MS*; Pinckard, J. Keith MD, PhD*†The American Journal of Forensic Medicine and Pathology: September 2011 - Volume 32 - Issue 3 - p 232-235 doi: 10.1097/PAF.0b013e318219ca5b Case Reports Abstract Author Information Thyrotoxic periodic paralysis is a rare and dramatic complication of hyperthyroidism. Thyrotoxic periodic paralysis classically presents with proximal lower limb weakness in the setting of hypokalemia and thyrotoxicosis. Thyrotoxic periodic paralysis represents an endocrine emergency with a rapidly ascending paralysis that can result in respiratory insufficiency, cardiac arrhythmias, and death if not accurately and rapidly diagnosed. We report a case of undiagnosed fatal thyrotoxic periodic paralysis presenting to the medical examiner. The diagnosis was made primarily by review of the clinical history. From the *Department of Pathology, University of Texas Southwestern Medical Center; and †Southwestern Institute of Forensic Sciences, Dallas, TX. Manuscript received July 22, 2008; accepted December 12, 2008. The authors report no conflicts of interest. Reprints: J. Keith Pinckard, MD, PhD, Southwestern Institute of Forensic Sciences, 5320 Medical Center Dr, Dallas, TX 75235. E-mail: email@example.com. © 2011 by Lippincott Williams & Wilkins.