| tick paralysis is a preventable cause of illness and death that, when diagnosed promptly, requires simple, low-cost intervention (tick removal). We reviewed information on cases of tick paralysis that were reported to the washington State Department of Health (Seattle) during 1946-1996. Thirty-three cases of tick paralysis were identified, including 2 in children who died. Most of the patients were female (76%), and most cases (82%) occurred in children aged <8 years. Nearly all cases with information on site of probable exposure indicated exposure east of the Cascade Mountains. Onset of illness occurred from March 14 to June 22. Of the 28 patients for whom information regarding hospitalization was available, 54% were hospitalized. dermacentor andersoni was consistently identified when information on the tick species was reported. This large series of cases of tick paralysis demonstrates the predictable epidemiology of this disease. Improving health care provider awareness of tick paralysis could help limit morbidity and mortality due to this disease. ( info) |
2/17. tick paralysis syndrome in a 5-year-old girl. tick paralysis syndrome (TPS) is an uncommon cause of ascending paralysis in children. Familiarity with its clinical features is important, since prompt diagnosis and removal of the tick is curative. We report the case of a 5-year-old girl with TPS manifested as lower extremity ataxia and paralysis and briefly discuss the salient features of TPS. ( info) |
| The authors report six patients with tick paralysis seen over 5 years. Clinical and electrodiagnostic findings failed to adequately distinguish tick paralysis from guillain-barre syndrome in these patients. Finding a tick attached to the scalp or the nape of the neck and removing it resulted in rapid clinical improvement. ( info) |
4/17. tick paralysis: electrophysiologic studies. A patient with tick paralysis had motor and sensory nerve conduction studies before and after removal of an engorged tick. The amplitudes of muscle action potentials evoked by stimulation of motor nerves were reduced initially, returning to normal after the tick was removed. Distal motor and sensory latencies also shortened after removal, and conduction velocities were improved 6 months later. Direct stimulation of muscle produced a normal response, and tests of neuromuscular transmission were normal, including the response to edrophonium. These findings are compatible with experimental results showing effects of the toxin on motor nerve terminals as well as on large sensory and motor nerves. ( info) |
| We report the case of a 17-month-old female with tick paralysis presenting to an urban los angeles emergency department. The tick was later identified as the North American wood tick, dermacentor andersoni, and was likely obtained while the family was vacationing on a dude ranch in montana. We discuss the epidemiology of tick paralysis, a differential diagnosis for health care providers, and methods of detection and removal. Given the increasing popularity of outdoor activities and ease of travel, tick paralysis should be considered in cases of acute or subacute weakness, even in an urban setting. ( info) |
6/17. ticks and tick paralysis: imaging findings on cranial MR. tick paralysis is an acute, progressive, and potentially fatal muscle paralysis secondary to a toxin secreted by a pregnant tick during a bite. Although tick bites can occur anywhere on the body, ticks are frequently overlooked on the scalp because of overlying hair. Children with acute neurologic symptoms frequently undergo MR scanning that may incidentally reveal the offending tick. Timely identification and removal of the tick leads to rapid recovery from tick paralysis. We report the MRI findings at 1.5 T of tick paralysis with an attached tick. ( info) |
| This report describes two cases of tick paralysis in children diagnosed within a 3-month period (May-July 2002) in rural south carolina. Differing presenting symptoms consisted of acute onset of ataxia in one patient and acute ascending paralysis in the other. ticks were present on the scalp of both patients and were removed immediately. Both girls demonstrated improvement of signs and symptoms within hours and complete recovery within 24 hours of tick removal. The diagnosis of tick paralysis must be considered in any patient, particularly children, who present with either acute ataxia or acute ascending paralysis. As in any clinical encounter, careful history and thorough general and neurologic examinations must be performed to exclude the possibility of tick attachment. ( info) |
8/17. tick paralysis: atypical presentation, unusual location. We present 2 unrelated cases of tick paralysis presenting within a 2-month period in the greater philadelphia region, a geographic area in which this disease is highly unusual. Our first patient demonstrated early onset of prominent bulbar palsies, an atypical presentation. Our second patient, residing in a nearby but distinct community, presented with ascending paralysis 2 months after the first. The atypical presentation of our first patient and the further occurrence within a few months of a second patient, both from the Northeastern united states where this diagnosis is rarely made, suggest the need to maintain a high index of suspicion for this disease in patients presenting with acute onset of cranial nerve dysfunction or muscle weakness. Through simple diagnostic and therapeutic measures (ie, careful physical examination to locate and remove the offending tick), misdiagnosis and unnecessary morbidity can be avoided. ( info) |
9/17. tick paralysis with atypical presentation: isolated, reversible involvement of the upper trunk of brachial plexus. tick paralysis is a disease that occurs worldwide. It is a relatively rare but potentially fatal condition. The only way to establish the diagnosis is to carefully search for the tick paralysis. It is caused by a neurotoxin secreted by engorged female ticks. tick paralysis generally begins in the lower extremities and ascends symmetrically to involve the trunk, upper extremities and head within a few hours. Although early-onset prominent bulbar palsy and isolated facial weakness without generalised paralysis are rare, there is no report in the English literature concerning isolated, reversible involvement of the upper trunk of brachial plexus caused by tick bite. We report a case of isolated, reversible involvement of the upper trunk of brachial plexus as a variant of tick paralysis. diagnosis was confirmed with needle electromyography and nerve conduction examination. Within 2 weeks, the patient was fully recovered. The purpose of presenting this case is to remind clinicians that tick paralysis should be considered even in cases with atypical neurological findings admitted to the emergency department. ( info) |
| tick paralysis is a rare disease characterized by acute, ascending, flaccid paralysis that is often confused with other acute neurologic disorders or diseases (e.g., guillain-barre syndrome or botulism). tick paralysis is thought to be caused by a toxin in tick saliva; the paralysis usually resolves within 24 hours after tick removal. During May 26-31, 2006, the colorado Department of public health and environment received reports of four recent cases of tick paralysis. The four patients lived (or had visited someone) within 20 miles of each other in the mountains of north central colorado. This report summarizes the four cases and emphasizes the need to increase awareness of tick paralysis among health-care providers and persons in tick-infested areas. ( info) |