We describe the clinical course of a 13-year-old Taiwanese girl presented with a change in consciousness (GCS: E1VeM1), generalized paralysis, and respiratory failure accompanied with transient hypertension. She required ventilator support for six days and all the neurologic deficits gradually recovered. We considered all the differential diagnoses of acute paralysis and respiratory failure. Neurotoxic snake bite was highly suspected. Her serial neurologic examinations were recorded in detail. If one has a clear understanding of the evolution of characteristic features, a specific diagnosis and treatment are possible.