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1/2. 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.
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2/2. epidemiology of tick-borne encephalitis in japan.

    A tick-borne encephalitis (TBE) patient has not been reported for many years in japan although a serological survey of domestic animal sera suggested the presence of TBE foci in Hokkaido, the northern island of japan. In October 1993 in Hokkaido, a severe encephalitis case in a farm wife was diagnosed as tick-borne encephalitis. Serological examination of paired sera showed a rise of neutralization (NT) antibody titer to Russian spring summer encephalitis virus. A sero-epizootiological survey of dogs showed that the TBE-related virus was prevalent in the area. Three virus isolates were obtained from the blood of sentinel dogs and the antigenic analysis grouped the isolates into TBE-related viruses. sequence analysis of envelope protein gene identified one of the isolates as the same subtype as Russian spring summer encephalitis (Far-Eastern TBE) virus. The results provide the evidence that TBE is endemic in a certain area of japan.
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keywords = tick
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