From the Research
Definition and Symptoms of Tick Paralysis
- Tick paralysis is a rare, but readily treatable condition that can lead to significant morbidity and death if missed 1.
- The classic clinical presentation of tick paralysis is the development of an unsteady, ataxic type gait followed by an acute symmetric ascending flaccid paralysis 1.
- Symptoms generally begin within 2 to 6 days of tick attachment and can progress to cranial nerve involvement if the tick continues to feed 1.
Diagnosis and Misdiagnosis
- Tick paralysis is often misdiagnosed as Guillain-Barré's syndrome, particularly the Miller Fisher's subtype, due to its similar presentation 1, 2.
- However, the weakness seen in tick paralysis progresses more quickly than in Guillain-Barré's syndrome, and the protein concentration is not elevated in the cerebrospinal fluid 1.
- A thorough examination and consideration of tick paralysis in the differential diagnosis can prevent unnecessary harm and misdiagnosis 2, 3.
Treatment and Recovery
- The mainstay of treatment for tick paralysis is tick removal 1, 4.
- The time to full neurologic recovery after tick removal is estimated to be around 1.5 days, with initial improvement generally within hours 1.
- In some cases, patients may experience atypical presentations, such as isolated, reversible involvement of the upper trunk of brachial plexus, which can still be treated with tick removal 3.