Tick paralysis

Definition 
Tick paralysis results from a tick bite.

Causes, incidence, and risk factors 

Hard- and soft-bodied female ticks are thought to produce a neurotoxin capable of causing paralysis in children. Ticks attach to the skin to feed on blood. It is during this feeding process that the toxin enters the bloodstream.

The resulting paralysis is ascending (starting in the lower body and moving up) and is similar to that seen in Guillain-Barre syndrome and opposite that seen in botulism and paralytic shellfish poisoning (descending).

Affected children develop an unsteady gait (ataxia) followed several days later by lower extremity weakness that gradually moves up to involve the upper limbs. Paralysis may cause loss of respiratory ability and the patient may require a ventilator.

Symptoms  

     
  • history of exposure to ticks such as camping, a tick-infested area, dogs or other animals  
  • finding a tick attached at the back of the neck at the hairline  
  • unsteady jerky body movements and gait (ataxia)  
  • muscle weakness beginning in the lower extremities and progressing upwards  
  • breathing difficulties

Signs and tests 
There may be a history of known or likely exposure to ticks such as camping, living in a tick-infested area, or having dogs or other animals.

Finding a tick embedded in the skin and noting above symptoms confirms the diagnosis. No other testing is required.

Treatment  
Removing the tick removes the source of the neurotoxin. Recovery is rapid following the removal of the tick.

Expectations (prognosis) 
Full recovery is expected following the removal of the tick.

Complications 

     
  • respiratory failure

Calling your health care provider 
If your child suddenly becomes unsteady or weak, have the child examined promptly. Breathing difficulties indicate a need for emergency care.

Prevention 

Insect repellents and protective clothing when out in tick-infested areas will help prevent attachment of ticks. A thorough search of the skin for ticks following an outing and removal of any found will prevent tick paralysis.

As a rule, if children are discovered to have ticks, it is a good idea to write the information down and keep it for several months. Many tick-borne diseases do not show symptoms immediately, and the incident may be forgotten by the time a child becomes ill with a tick-borne disease.

Johns Hopkins patient information

Last revised: December 7, 2012
by Mamikon Bozoyan, M.D.

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