A patient presents with ascending muscle weakness for 2 days. On examination, the limb is flaccid. What investigation should be done first?
Serum potassium
Serum creatinine
Serum magnesium
Serum calcium
Answer- A. Serum potassiumHypokalemia can cause flaccid ascending paralysis, which is a differential diagnosis for GBS. It can also cause periodic paralysis. Hypocalcemia and hypomagnesemia usually cause tetany and hypercalcemia won't cause ascending paralysis.A low serum potassium level during an attack, excluding secondary causes, establishes the diagnosis of Hypokalemic Periodic Paralysis.