Tick paralysis

Background

1. Caused by neurotoxin produced by certain ticks in the US and Australia
2. Most cases reported in children

Clinical Features

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

Diagnosis

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

Treatment

1. Remove tick as quickly as possible with tweezers
2. Supportive care (resolves on its own)

Source

• Tintinalli