Post-operative hyperkalaemic paralysis.

Tetraparesis is more often a clinical feature of profound hypokalaemia 1, 2 than hyperkalaemia. Neurological features ofhyperkalaemia are rarely seen in clinical practice, as they are precluded by cardiotoxic complications such as arrhythmias. However, patients may develop flaccid paralysis of skeletal muscle with areflexia mimicking symptoms of acute inflammatory demyelinating polyneuropathy.3 Severe hyperkalaemic paralysis has previously been reported secondary to nonsteroidal anti-inflammatory drugs 4 spironolactone,5 and a combination of chronic renal failure and ACE inhibitors.6 We report a case of post-operative secondary hyperkalaemic paralysis presenting with neurological symptoms 18 days after an anterior resection (with diverting loop ileostomy) for a rectosigmoid colonic adenocarcinoma.