Hyperthyroidism · myalgia · rapidly progressing paralysis · Dx?

A 26-year-old Hispanic woman presented to the emergency department (ED) with myalgia and weakness. There were no prior symptoms and family history was negative for endocrinopathies. She was admitted and started on methimazole 10 mg twice a day for thyroid suppression and given propranolol 10 mg twice a day for anticipated hyperadrenergic adverse effects. The remainder of her hospital stay was uneventful and she was discharged 6 days after admission. Soon after, an outpatient thyroid scan ordered by her primary care physician confirmed that the patient had Graves' disease.