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Semin Neurol 2004; 24(2): 181-184
DOI: 10.1055/s-2004-830905
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Tick Paralysis

V. Vedanarayanan1 , W. H. Sorey2 , S. H. Subramony3
  • 1Professor of Pediatrics and Associate Professor of Neurology, University of Mississippi Medical Center, Jackson, Mississippi
  • 2Associate Professor of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi
  • 3Professor and Vice Chairman of Neurology, University of Mississippi Medical Center, Jackson, Mississippi
Further Information

Publication History

Publication Date:
15 July 2004 (online)

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Tick paralysis results from inoculation of a toxin from tick salivary glands during a blood meal. It is a relatively uncommon neuromuscular disease with a higher prevalence among young girls, although older men who get exposed to ticks may also be affected. It typically presents as an acute ascending paralysis occurring a few days after tick attachment and may result in respiratory failure and death. Patients may report minor sensory symptoms but constitutional signs are usually absent. Deep tendon reflexes are usually hypoactive or absent and ophthalmoplegia and bulbar palsy can occur. Children may be ataxic. Electromyographic studies usually show a variable reduction in the amplitude of compound muscle action potentials but no abnormalities of repetitive nerve stimulation studies. These appear to result from a failure of acetylcholine release at the motor nerve terminal level. There may be subtle abnormalities of motor nerve conduction velocity and sensory action potentials. Removal of the tick results in the very rapid reversal of clinical and physiologic deficits, quicker with North American ticks than with the Ixodes species seen in Australia.

KEYWORDS

Ticks - paralysis - compound muscle action potentials - repetitive nerve stimulation - motor nerve terminal

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S. H SubramonyM.D. 

Department of Neurology, University of Mississippi Medical Center

2500 North State Street, Jackson, MS 39216

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