A diagnostic dilemma: Severe hypokalemia presenting with GBS-like clinical feature.

Abstract

Acute flaccid paralysis is a potentially life- threatening presentation necessitating prompt and precise diagnosis. Guillain-Barre’ Syndrome (GBS) is often the first consideration due to its prevalence and severity. However, non-neurological conditions, particularly metabolic disturbances such as hypokalemia, can clinically and electrophysiologically mimic GBS. Hypokalemic paralysis, albeit rare, represents a reversible etiology of acute limb weakness. It may present with symptoms indistinguishable from GBS, including areflexia and ascending limb paralysis, resulting in a diagnostic dilemma. A misdiagnosis can delay appropriate treatment and subject the patient to unnecessary interventions. This case report elucidates a patient who exhibited classic features of GBS but was ultimately diagnosed with severe hypokalaemia. It underscores the imperative of good clinical assessments including correctly identifying serum electrolytes abnormalities in all patients presenting with acute neuromuscular weakness.