Autonomic dysfunction with areflexic quadriplegia: An unusual presentation of snake envenomation

Rapidly progressing descending areflexic quadriplegia with autonomic dysfunction in the form of hypertension, tachycardia, hypersalivation, sweating and lacrimation in the absence of proper history from attendants poses a challenge in emergency area. Neuroparalytic snake envenomation by elapid species has been known to produce autonomic symptoms and even locked-in states. Here we present a case of young male with rapidly progressing areflexic quadriplegia with autonomic dysfunction; with no documented history of snake bite who improved after antisnake venom and ventilatory support.