Vector

Tick Paralysis

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Tick Paralysis, Tick Toxicosis

  • See Also
  1. Tick-Borne Disease
  2. Vector Borne Disease
  3. Prevention of Tick-borne Infection
  4. Tick Removal
  • Epidemiology
  1. Northwest United States
  2. Peak onset in spring: April to June
  • Pathophysiology
  1. Neurotoxin secretion during tick attachment or feeding via Saliva (non-infectious)
  2. Occurs with Female ticks of several species
    1. Dermacentor (e.g. American Dog Tick, Rocky Mountain Wood Tick)
    2. Amblyomma (e.g. Gulf Coast Tick)
    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 (typically within 24 hours)
  • Prevention
  1. See Prevention of Vector-borne Infection
  • 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
  2. Pensa and Werner in Swadron (2022) EM:Rap 22(5): 8-12