Vector

Tick Paralysis

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Tick Paralysis, Tick Toxicosis

  • Epidemiology
  1. Northwest United States
  2. Peak onset in spring: April to June
  • 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
  • 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]
  • Differential Diagnosis
  1. Guillain-Barre Syndrome
    1. Tick Paralysis progresses more rapidly than Guillain-Barre Syndrome
  • Management
  1. Removal of tick is curative
  • Prognosis
  • Unrecognized infection (tick not removed)
  1. Progresses to Respiratory Failure and death
  • References
  1. Green and Millsap (2016) Crit Dec Emerg Med 30(1): 4