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Semin Neurol 2012; 32(05): 531-532
DOI: 10.1055/s-0033-1334474
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Tick Paralysis

Cara Ann Pecina
1   Department of Neurology, University of Cincinnati College of Medicine, Cincinnati, OH
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Publikationsdatum:
15. Mai 2013 (online)

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Abstract

Tick paralysis is a rare, but readily treatable condition that if missed can lead to significant morbidity and death. The classic clinical presentation of tick paralysis is the development of an unsteady, ataxic type gait followed by an acute symmetric ascending flaccid paralysis. Symptoms generally begin within 2 to 6 days of tick attachment. If the tick continues to feed, the weakness ascends to the upper extremities over a matter of hours, followed by cranial nerve involvement. Due to the similarity in its presentation, tick paralysis is often misdiagnosed as Guillain–Barré's syndrome, particularly the Miller Fisher's subtype, given its cranial nerve involvement. However, the weakness seen in tick paralysis progresses more quickly than what is generally seen in Guillain–Barré's syndrome and the protein concentration is not elevated in the cerebrospinal fluid. The mainstay of treatment for tick paralysis is tick removal. The time to full neurologic recovery after tick removal is estimated to be around 1.5 days with initial improvement generally within hours.

Keywords

tick paralysis
 

  • References

  • 1 Gentile DA, Lang JE. Tick-borne diseases. In: Auerbach PS, , ed. Wilderness Medicine. 4th ed. St. Louis, MO: Mosby; 2001: 769-806
    Google Scholar
  • 2 Vedanarayanan V, Sorey WH, Subramony SH. Tick paralysis. Semin Neurol 2004; 24 (2) 181-184
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 3 Cooper BJ, Spence I. Temperature-dependent inhibition of evoked acetylcholine release in tick paralysis. Nature 1976; 263 (5579) 693-695
    CrossrefPubMedGoogle Scholar
  • 4 Emmons P, McLennan H. Failure of acetylcholine release in tick paralysis. Nature 1959; 183 (4659) 474-475
    CrossrefPubMedGoogle Scholar
  • 5 Rose I. A review of tick paralysis. Can Med Assoc J 1954; 70 (2) 175-176
    PubMedGoogle Scholar
  • 6 Schmitt N, Bowmer EJ, Gregson JD. Tick paralysis in British Columbia. Can Med Assoc J 1969; 100 (9) 417-421
    PubMedGoogle Scholar
  • 7 Edlow JA, McGillicuddy DC. Tick paralysis. Infect Dis Clin North Am 2008; 22 (3) 397-413 , vii
    CrossrefPubMedGoogle Scholar
  • 8 Diaz JH. Tick paralysis in the United States. J La State Med Soc 2010; 162 (5) 273-280
    PubMedGoogle Scholar
  • 9 Grattan-Smith PJ, Morris JG, Johnston HM , et al. Clinical and neurophysiological features of tick paralysis. Brain 1997; 120 (Pt 11) 1975-1987
    CrossrefPubMedGoogle Scholar
  • 10 Miller MK. Massive tick (Ixodes holocyclus) infestation with delayed facial-nerve palsy. Med J Aust 2002; 176 (6) 264-265
    PubMedGoogle Scholar
  • 11 Lagos JC, Thies RE. Tick paralysis without muscle weakness. Arch Neurol 1969; 21 (5) 471-474
    CrossrefPubMedGoogle Scholar
  • 12 Dworkin MS, Shoemaker PC, Anderson Jr DE. Tick paralysis: 33 human cases in Washington State, 1946–1996. Clin Infect Dis 1999; 29 (6) 1435-1439
    CrossrefPubMedGoogle Scholar
  • 13 Vedanarayanan VV, Evans OB, Subramony SH. Tick paralysis in children: electrophysiology and possibility of misdiagnosis. Neurology 2002; 59 (7) 1088-1090
    CrossrefPubMedGoogle Scholar
  • 14 Diaz JH. A 60-year meta-analysis of tick paralysis in the United States: a predictable, preventable, and often misdiagnosed poisoning. J Med Toxicol 2010; 6 (1) 15-21
    CrossrefPubMedGoogle Scholar
  • 15 Needham GR. Evaluation of five popular methods for tick removal. Pediatrics 1985; 75 (6) 997-1002
    PubMedGoogle Scholar