Causes:
(1) acute alcohol intoxication with acute hypokalemia secondary to vomiting and/or diarrhea
(2) chronic alcohol abuse
(3) renal tubular damage secondary to volatile substance abuse
(4) renal tubular acidosis
(5) hyperaldosteronism
(6) steatorrhea
(7) drug-induced
Clinical findings:
(1) muscle weakness, often proximal
(2) variable myalgias
(3) preserved reflexes
(4) reversal of weakness on potassium repletion
An EMG shows myopathic changes.
Laboratory findings:
(1) serum hypokalemia with marked depletion of total body potassium stores
(2) elevated serum creatine kinase (CK)
The acute hypokalemic myopathy associated with alcohol intoxication is painless and associated with vacuolar degeneration and necrosis of muscle fibers.
Differential diagnosis:
(1) hypokalemic periodic paralysis
(2) other causes of myopathy
