Cases reported "Tick Toxicoses"

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1/9. 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.
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2/9. Severe tick-bite fever in young children. A report of 3 cases.

    Tick-bite fever in young children is usually a mild illness with few complications and no mortality. That it may assume a severe form is illustrated by the occurrence of 3 cases admitted to Johannesburg Hospital within 1 week in which 2 patients, 3 and 5 years old respectively, had severe involvement of the central nervous system with epileptiform fits and deep coma and loss of power of speech on recovering consciousness. The third patient, aged 5 years, developed an incipient haemorrhagic state as well as serious involvement of the central nervous system. The severe form of the disease in these patients appears to have been due to unusually virulent strains of rickettsia conorii, probably acquired from dog ticks in their homes. All patients recovered on appropriate treatment. Two regained their normal speech after many weeks while the third patient's incipient haemorrhagic state rapidly resolved.
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3/9. Paralysis with ixodes cornuatus envenomation.

    ixodes cornuatus is a tick that is widely distributed in victoria, tasmania and southern new south wales. Serious human envenomation has not been reported previously. The clinical syndrome that results from envenomation by ixodes cornuatus in a three-year-old boy is presented. Bulbar palsy and respiratory failure necessitated endotracheal intubation and mechanical ventilation for five days. Canine tick antivenom was administered.
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4/9. Tick toxicosis in north america.

    This is a case presentation and review of an uncommon disorder, tick toxicosis. The history, epidemiology, pathophysiology, and treatment are discussed. This disorder was mentioned in diaries from the early 1800s and has been reported in 18 states and the district of columbia. A review of 70 cases reveals that the typical patient is a female child who develops leg weakness, irritability, or clumsiness. The exact site at which the toxin induces the paralysis is unknown. Removal of the tick usually reverses the paralysis within hours. Confusing tick toxicosis with other disorders may occur, and death has resulted. This article will remind physicians to consider tick toxicosis when seeing patients with acute ataxia or ascending paralysis and to, perhaps, prevent death from an easily treatable disorder.
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5/9. tick paralysis in three children. The diversity of neurologic presentations.

    Reviewed are 3 cases of tick paralysis in children each with a different presentation. One child presented with an ascending flaccid weakness, another with weakness and cerebellar signs, and a third with pure cerebellar signs. ixodes scapularis, the black-legged deer tick, was the offending tick in Case 3 and apparently has not been previously reported to cause paralysis in humans. Because of the potential for a fatal outcome, it is imperative to consider tick paralysis in any child with an ascending flaccid weakness or acute ataxia.
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6/9. Tick-bite fever in south africa. The occurrence of severe cases on the Witwatersrand.

    Tick-bite fever, the variety of tick typhus occurring in southern Africa, is caused by Rickettsia conori var. pijperi and is transmitted by hard or ixodid ticks. It is usually a mild disease, especially in children and young adults, but in middle-aged and elderly patients (and sometimes in young adults) it may assume a severe form. This is characterized by high fever, severe headache, delirium, stupor and occasionally coma, and a profuse maculopapular rash which becomes haemorrhagic and is associated with petechiae in the skin and later, but rarely, by the development of gangrene of the fingers and toes. During these severe attacks the central nervous system may be involved and marked disorders of liver and kidney function sometimes lead to kidney failure and the need for treatment and dialysis in an intensive care unit. Three illustrative cases are described in which diagnosis was delayed. One patient died; 2 patients responded to administration of tetracycline. The danger of allowing tick-infested dogs onto one's bed is stressed. Infections transmitted by dog ticks tend to be more severe than those acquired via ticks from the bushveld, possibly because they so often occur in middle-aged and elderly patients. Serological tests have recently indicated that there are antigenic differences between 'suburban' and 'bushveld' strains; these clearly require further study.
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7/9. Combined recordings of compound nerve action potentials and spinal cord evoked potentials in differential diagnosis of spinal root lesions.

    Three cases are presented to demonstrate the diagnostic value of sensory neurography in combination with somatosensory evoked potentials in the diagnosis of proximally located neuropathy and its differentiation to centrally located demyelinating processes. Simultaneous recording of cortical and spinal evoked potentials, as well as peripheral nerve action potentials, revealed in two cases (herpes zoster, guillain-barre syndrome) a site of lesion at the spinal roots suggesting radiculitis and in one case (tick bite) a site of lesion central to the source of lumbar evoked potentials suggesting myelitis. In all cases almost complete recovery of sensory conduction velocities suggests a complete repair myelination not previously described.
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8/9. tick paralysis: electrophysiologic measurements.

    Electrophysiologic measurements in a 9-year-old girl with tick paralysis demonstrated a prolonged distal latency and a decremental response to 30 Hz stimulation. The nerve conduction determinations became normal after clinical recovery. The pathophysiologic process of this disease seems to be within the peripheral nerve although a central site of action of tick toxin cannot be completely excluded. tick paralysis should be considered in the individual who develops ascending paralysis.
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9/9. The clinical features of tick bite.

    The clinical features of bites by the Australian scrub tick, ixodes holocyclus, are reviewed. Eight cases of tick bite are summarized, including six new cases of tick paralysis in children. In almost all cases neuroparalysis became worse transiently, after the tick had been removed. One child with life-threatening respiratory and bulbar palsy received canine antitick antivenene, with rapid reversal of clinical signs. The differential diagnosis of tick bite includes all acute childhood diseases which can affect the motor units; the importance of including the possibility of tick envenomation in the differential diagnosis of acute weakness or paralysis in children is illustrated. The clinical features of neuromuscular paralysis are described, together with a review of the tick's local effects at the bite site.
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