Ver el código de «Tick paralysis»

==Background==
*Caused by neurotoxin produced by certain ticks (e.g. ''Ixodes holocyclus'') in the US and Australia
*Most cases reported in children

==Pathophysiology==
Paralysis results from the neurotoxin “ixobotoxin,” which inhibits the release of acetylcholine at
the neuromuscular junction and autonomic ganglia, very similar to botulinum toxin.

==Clinical Features==
*Symptoms begin 2-6d after attachment of tick
**Ataxia -> symmetric ascending flaccid paralysis w/ loss of DTRs
*Presentation can be identical to Guillain-Barre including progression to resp paralysis 
**Unlike GBS, may have ocular signs (e.g. fixed and dilated pupils)

==Differential Diagnosis==
{{Tick borne illnesses DDX}}
{{Weakness DDX}}

==Diagnosis==
*Sensory abnormalities and elevation of CSF protein level do not occur
*Progression and resolution of sx (w/ tick removal) is faster than in Guillain-Barre 

==Treatment==
*Remove tick as quickly as possible with tweezers
**Proper removal of the tick is very important incomplete removal may infect the patient.
***The tick should be grasped as close to the skin surface as possible with blunt curved forceps, tweezers, or gloved hands. Steady pressure without crushing the body should be used. After tick removal, the site should be disinfected. 
***Traditional methods of tick removal using petroleum jelly, topical lidocaine, ﬁngernail polish, isopropyl alcohol, or a hot match head are ineffective and may induce the tick to salivate or regurgitate into the wound. <ref>http://www.cdc.gov/ticks/removing_a_tick.html</ref>
**Removal of Ixodes tick does not result in improvement for days to weeks. 
*Supportive care (resolves on its own)

==References==

[[Category:ID]]