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Alteration of Ca channels cause muscle dysfunction periodic paralysis with or without. tion in acetazolamide-responsive myotonia congenita, pa-. ceptor 1 subunit gene for mutations causing hypokalemic. Thyrotoxic Periodic Paralysis (TPP) is a potentially lethal manifestation of hyperthyroidism which is characterized by hypokalemia and muscular weakness. It mainly affects. Acetazolamide has no role in the treatment of TPP. 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