II. Epidemiology
- Northwest United States
- Peak onset in spring: April to June
III. Pathophysiology
- Neurotoxin secretion during tick attachment or feeding via Saliva (non-infectious)
- Occurs with Female ticks of several species
- Dermacentor (e.g. American Dog Tick, Rocky Mountain Wood Tick)
- Amblyomma (e.g. Gulf Coast Tick)
- Ixodes
IV. Findings
- Acute ascending Flaccid Paralysis
- Onset 2-6 days after Tick Bite
- Neurologic progression
- Difficulty walking or standing
- Ataxia
- Absent Deep Tendon Reflexes
- Drooling
- Tachypnea
- Girls under age 10 years old may have unique presentations
- Ataxia
- Weakness without sensory loss
- Graham (2011) Pediatr Emerg Care 27(2): 141-7 [PubMed]
V. Differential Diagnosis
-
Guillain-Barre Syndrome
- Tick Paralysis progresses more rapidly than Guillain-Barre Syndrome
VI. Management
- Removal of tick is curative (typically within 24 hours)
VII. Prevention
VIII. Prognosis: Unrecognized infection (tick not removed)
- Progresses to Respiratory Failure and death
IX. References
- Green and Millsap (2016) Crit Dec Emerg Med 30(1): 4
- Pensa and Werner in Swadron (2022) EM:Rap 22(5): 8-12
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Related Studies
Definition (MSH) | Paralysis caused by a neurotropic toxin secreted by the salivary glands of ticks. |
Concepts | Disease or Syndrome (T047) |
MSH | D013985 |
SnomedCT | 74225001 |
English | Paralyses, Tick, Tick Paralyses, Tick Paralysis, Paralysis, Tick, tick paralysis, tick paralysis (diagnosis), Tick Paralysis [Disease/Finding], paralysis tick, Tick bite paralysis, Tick paralysis, Tick paralysis (disorder), paralysis; tick, tick; paralysis |
Swedish | Fästingparalys |
Czech | klíšťová paralýza |
Finnish | Punkkihalvaus |
Russian | KLESHCHEVOI PARALICH, КЛЕЩЕВОЙ ПАРАЛИЧ |
Polish | Porażenie kleszczowe |
Norwegian | Tick Paralysis |
Italian | Paralisi da morso di zecca, Paralisi da zecca |
Dutch | paralyse; teek, teek; paralyse, Tekenbeet, verlamming ten gevolge van, Verlamming ten gevolge van tekenbeet |
Spanish | parálisis por garrapatas (trastorno), parálisis por garrapatas, Parálisis por Garrapatas |
German | Zeckenparalyse |
Portuguese | Paralisia por Carrapato |
French | Paralysie due aux tiques, Paralysie par piqûre de tique |
Ontology: Tick Toxicoses (C0040198)
Definition (MSH) | Toxicoses caused by toxic substances secreted by the salivary glands of ticks; include tick paralysis (neurotropic toxin), sweating sickness (dermotropic toxin), and Rhipicephalus appendiculatus toxicosis (leukotropic toxin). |
Concepts | Disease or Syndrome (T047) |
MSH | D013986 |
English | Tick Toxicoses, Toxicoses, Tick, Tick Toxicoses [Disease/Finding] |
Swedish | Fästingtoxikoser |
Czech | klíšťové toxikózy |
Finnish | Punkkitoksikoosit |
Russian | KLESHCHEVYE TOKSIKOZY, КЛЕЩЕВЫЕ ТОКСИКОЗЫ |
Polish | Zatrucie jadem kleszczowym |
Norwegian | Toksikose fra flått |
Spanish | Toxicosis por Garrapata, Toxicosis por Garrapatas |
Portuguese | Toxicose por Carrapato, Toxicoses por Carrapatos |
German | Zeckentoxikosen |
Italian | Tossicosi da zecca |
Dutch | Tekenbeet, toxicose ten gevolge van, Toxicose ten gevolge van tekenbeet |
French | Accident toxique dû aux tiques, Accidents toxiques dus aux tiques, Toxicoses par piqûres de tiques |