Hypokalaemic periodic paralysis unresponsive to acetazolamide

The cases of a 14-year-old farm labourer is presented as a further example of nonacetazolamide responsive hypokalaemic periodic paralysis. The family history was negative, the clinical picture classical, with prompt reversal of symptoms after the use of potassium salts. However, the administration of acetazolamide led to precipitation of an attack within a few days. The use of triamterene 100mg daily resulted in complete cessation of the attacks for the last 12 months with the maintenance of normal serum potassium levels without the use of supplementary potassium.