Muscles of the mouth and throat, eyes, and breathing are usually not affected, but occasionally weakness of the respiratory muscles can cause life-threatening respiratory failure. Attacks typically resolve within several hours to several days, even in the absence of treatment. On neurological examination during an attack, flaccid weakness of the limbs is noted; reflexes are usually diminished, but the sensory system is unaffected. Mental status is not affected.Attacks may be brought on by physical exertion, drinking alcohol, or eating food high in carbohydrates or salt. This may explain why attacks are more common in summer when more people drink sugary drinks and engage in exercise. Exercise-related attacks tend to occur during a period of rest immediately after exercise; exercise may, therefore, be recommended to abort an attack.There may be symptoms of thyroid overactivity, such as weight loss, a fast heart rate, tremor, and perspiration; but such symptoms occur in only half of all cases. The most common type of hyperthyroidism, Graves disease, may additionally cause eye problems (Graves ophthalmopathy) and skin changes of the legs (pretibial myxedema). Thyroid disease may also cause muscle weakness in the form of thyrotoxic myopathy, but this is constant rather than episodic. Causes
Genetics
Genetic mutations in the L-type calcium channel α1-subunit (Cav1.1) have been described in Southern Chinese with TPP. The mutations are located in a different part of the gene from those described in the related condition familial periodic paralysis.
Efavirenz/lamivudine/tenofovir (EFV/3TC/TDF), sold under the brand name Symfi among others, is a fixed-dose combination antiretroviral medication for the treatment of HIV/AIDS. It combines efavirenz, lamivudine, and tenofovir disoproxil. As of 2019, it is listed by the World Health Organization as an alternative first line option to dolutegravir/lamivudine/tenofovir. It is taken by mouth.Side effects can include joint pain, sleepiness, headaches, depression, trouble sleeping, and itchiness. Severe side effects may include depression, psychosis, or osteonecrosis. In those with a history of epilepsy, it may increase the frequency of seizures. Greater care should also be taken in those with kidney problems. Its use during pregnancy appears to be unsafe.It is on the World Health Organizations List of Essential Medicines. The combination received tentative approval in the United States in 2014, and was granted approval in February 2018. Its availability and importance is supported by Medecins Sans Frontieres. It is available as a generic medication. References
External links
"Efavirenz". Drug Information Portal. U.S. National Library of Medicine. "Lamivudine". Drug Information Portal. U.S. National Library of Medicine. "Tenofovir disoproxil". Drug Information Portal. U.S. National Library of Medicine. "Tenofovir disoproxil fumarate". Drug Information Portal. U.S. National Library of Medicine.