Hypokalemic paralysis mimicking Guillain-Barré syndrome and causing acute respiratory failure.

A 33-year-old female patient admitted to the ICU with ascending muscle weakness leading to acute hypercapneic respiratory failure. She gave a 10-day history of severe diarrhea and vomiting. Laboratory work up revealed severe hypokalemia, mixed metabolic and respiratory acidosis, and renal impairment. Continuous potassium replacement produced rapid and complete recovery from quadriplegia and respiratory failure without requirement for mechanical ventilation.