Tick paralysis

• Definition: a rare syndrome caused by the salivary neurotoxin of certain ticks, characterized by acute ataxia, that progresses to ascending paralysis
• Distribution: most commonly in the Rocky Mountains and northwestern US
• Pathophysiology
  • Paralysis is caused by tick neurotoxin, which is produced in the tick’s salivary gland and introduced into the person’s blood.
• Clinical features
  • Symptoms begin within 2–7 days of the initial tick bite.
  • Typically starts with weakness in the lower extremities
  • Escalates to ascending flaccid paralysis that progresses rapidly and can lead to respiratory failure due to respiratory muscle weakness
  • Sensory deficits are usually absent.
  • Cranial nerve palsies may occur (e.g., CN III palsy).
  • No fever or rash
• Treatment
  • Locate and remove the tick
    • Removal of ticks usually results in improvement within 1 hour w/ recovery after several days