Secondary hypokalaemic paralysis.

A 28-year-old man presented with acute onset, ascending-type and bilateral symmetrical areflexic motor paralysis. There was a history of fever 3 days prior to paralysis, multiple episodes of vomiting, chloroquine use and intravenous dextrose administration. Investigations revealed metabolic alkalosis with normal serum potassium level but ECG showed characteristic changes of hypokalaemia based on which patient was managed successfully. This case highlights the importance of ECG findings of hypokalaemia in the presence of non-confirmatory laboratory values while evaluating a case of acute flaccid quadriplegia.