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Hyperkalemia, which refers to an elevated level of potassium in the blood, is often associated with muscle weakness and paralysis. High potassium levels can interfere with the normal electrical activity of muscle cells, particularly those in the skeletal muscles. This can result in symptoms ranging from mild muscle weakness to severe paralysis. The physiological mechanism involves potassium's critical role in the depolarization and repolarization phases of action potentials in muscle fibers. As potassium accumulates, it can lead to decreased excitability of these fibers, manifesting as weakness or paralysis.

While other symptoms such as difficulty breathing may occur due to respiratory muscle involvement or other complications associated with hyperkalemia, they are not as directly tied to the condition as muscle weakness. Additionally, increased heart rate and visual disturbances are not typical features of hyperkalemia, further supporting the association of muscle weakness or paralysis as the most prominent clinical manifestation.