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Neurologic complications of hypokalemia and hyperkalemia
What are the most common neurologic complications of hypokalemia and hyperkalemia?
Myalgias and weakness can be found with serum potassium concentrations of 2.5 to 3.0 mEq/L. Prolonged hypokalemia of less than 2.5 mEq/L will lead to rhabdomyolysis, myoglobinuria, and cardiac arrhythmias.
Hyperkalemia (>6.0 mEq/L) likewise causes functional and structural muscle abnormalities, including weakness and cardiac arrhythmias.
Ventricular asystole or fibrillation is life threatening and occurs long before neurologic symptoms are usually manifested.
The few previous reports of drowsiness, lethargy, and coma in hypokalemia may actually be the result of acid–base disequilibrium.
Sources
Horak HA, Pourmand R: Endocrine myopathies. Neurol Clin 18:203-213, 2000. Tesfaye S, Boulton AJ, Dyck PJ, et al.: Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care 33:2285-2293, 2010.
