Could this be a Potassium issue or Stroke?

Patient

Q: My grandmother is 97. She woke up and couldn't walk. She complained that her right foot was in a lot of pain. I tried calling to get her an appointment, but her doctors line stayed busy. The next day she could take some steps. I got in touch with her doctor's office. I was told they were booked solid and would be closed the rest of the week for Christmas. I said, "My grandmother is 97 and can barely walk." I was told to go to the hospital for an ex-ray. I did, and only inflammation showed up. I had to wait until the following Tuesday to find that out. She could walk better through Christmas. On January 1st, her neck and shoulder were hurting. We took her to the hospital. The doctor on call said her potassium was 1.7. After researching that, I realized how dangerous this was. Withing a couple of days, her potassium was up to 3.2. However, I could see changes in her daily. She knew us well and communicated well. By Saturday, we could still communicate but couldn't make out what she was saying as well. She had extreme muscle drawing that night for three hours. We could see the muscles in her legs and feet drawing. We tried messaging them. She was given Ibuprofen. We ask for something stronger because she was in a great deal of pain. She never got anything except a heat pad and muscle relaxer cream. She was exhausted and finally went to sleep. The next day, she couldn't swallow very well. I fed her some cream of chicken soup. She could not drink from a straw the way she did before. She would blow in it. The brought her medicine crunched up in apple sauce. I told them I didn't think she could take it that way. She got choked really bad on it. She couldn't breath in or out. I was patting her back and telling her to breath. She finally took a breath. Once again there was lots of gurgling noises made and she got choked again. The nurses suctioned her out. That was the last time she had anything by mouth. She has not had anything by mouth for 1 week and 1/2. She is on an IV. She is now off the potassium because the level is good. She gets something for high blood pressure which seems to stay normal in the day but increases at night. She can not speak, she can not move anything but her head a little, and she can not open her eyes. To look at her you would think she had a stroke. Her MRI and CT scan did not reveal that. You can actually see muscles tightening in her leg and back of neck. Could the low potassium cause all of this? Can it get you to a point of not being able to talk and muscles drawing even if the levels of potassium are good? She now weighs 92 pounds. We don't know what to do. I realize she is 97 but it seems that no one cares.

Symptoms:  Opens eyes for a few seconds daily, tries to speak but can only say a few words. She can hear us and knows who we are. visible muscles drawing in legs and back of neck
Doctor

A:   Hello, Welcome to Ask The Doctor.
Low pottasium (Hypokalemia) causes Hypokalemic Periodic Paralysis but it is usually Bilateral.
Since her only one leg was effected, low potassium can be a contributing factor but not the whole sole culprit.
It seems to be an orthopedic issue.
However, Stroke needs to be ruled out.
I would advise you to see an orthopedic surgeon. He will evaluate her and if no orthopedic cause if found, will refer her to Neurologist, who would get her CT scan brain, Kidney function tests for further evaluation.
I hope it helps.
Stay Healthy.

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