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Preponderance of Hypokalaemia as a Cause of Acute Onset Quadriparesis in Northern India/Southern Nepal

Of 68 patients who were admitted with acute quadriparesis to a hospital in northern India, over 70% were found to be hypokalaemic. The most common cause of hypokalaemia was that associated with gastroenteritis (54%). These patients had all received intravenous fluids previously. It is likely that their hypokalaemia was caused by gastrointestinal loss compounded by parenteral fluid replacement. The next most common group of hypokalaemia-associated quadriparesis had no obvious cause for hypokalaemia (38%). Hypokalaemia-induced quadriparesis is a potentially life-threatening illness which can be readily treated with potassium supplements. The physician should consider hypokalaemia in patients who present with acute onset quadriparesis, and even if diagnostic tests for hypokalaemia are not available, should consider a judicious trial of potassium supplementation empirically, provided that there are no contraindications.