Periodic Paralysis

To the Editor:—  The theory regarding the central neural origin of periodic paralysis (Editorial, JAMA186:422 [Oct 26] 1963) is not new. Pudenz, McIntosh, and McEachern (1938) suspected that the defect responsible for paralysis lies in the central neural system. Disturbances in the hypophyseal-hypothalamic region are described in three other papers published by others, and cited in Gamstorp's essay.¹It is uncertain if a primary neural disturbance influences the migration of potassium or if the reverse occurs. Anyhow, scant clinical attention has been given to sweating, fever, paresthesias, disturbed reflexes, ptosis, penile erections, mucosal congestion, thirst, polyuria, oliguria, anuria, hypotension, cardiac irregularities, and other autonomic responses incidental to episodes of periodic paralysis. A diencephalic disturbance may have a primary causal relation to periodic paralysis and to other periodic disorders.²