In all emergency departments, acute neuromuscular weakness, which is linked to  respiratory failure, is a common neurological emergency. Guillain-Barr´e Syndrome  (GBS) remains the leading cause of acute ascending quadriplegia presents with ascending  muscle weakness associated with paresthesia and loss of deep tendon reflexes and usually  preceeded by diarrheal illness or upper airway infection. Here we report 20-year-old  female presented with rapidly progressing, ascending weakness of all four extremities  for 24 hours duration with subsequently complicated by respiratory paralysis due to  severe hypokalemia.