II. Epidemiology

  1. Northwest United States
  2. Peak onset in spring: April to June

III. Pathophysiology

  1. Neurotoxin secretion during tick attachment or feeding via Saliva
  2. Occurs with Female ticks of several species
    1. Dermacentor
    2. Amblyomma
    3. Ixodes

IV. Findings

  1. Acute ascending Flaccid Paralysis
    1. Onset 2-6 days after Tick Bite
  2. Neurologic progression
    1. Difficulty walking or standing
    2. Ataxia
    3. Absent Deep Tendon Reflexes
    4. Drooling
    5. Tachypnea
  3. Girls under age 10 years old may have unique presentations
    1. Ataxia
    2. Weakness without sensory loss
    3. Graham (2011) Pediatr Emerg Care 27(2): 141-7 [PubMed]

V. Differential Diagnosis

  1. Guillain-Barre Syndrome
    1. Tick Paralysis progresses more rapidly than Guillain-Barre Syndrome

VI. Management

  1. Removal of tick is curative

VIII. Prognosis: Unrecognized infection (tick not removed)

  1. Progresses to Respiratory Failure and death

IX. References

  1. Green and Millsap (2016) Crit Dec Emerg Med 30(1): 4

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Related Studies

Ontology: Tick Paralysis (C0040197)

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
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
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