Monday, June 24, 2019

Tick paralysis

A Colorado mother is sharing her daughter’s health scare in hopes of helping other parents stay vigilant about tick-related illnesses. Heidi Ganahl, a mother of four and founder of SheFactor, said she had noticed a few ticks hidden in her 7-year-old’s hair after she returned from an overnight
camp. Ganahl said she removed the ticks from Jenna’s hair and called the doctor, but 10 days later her daughter’s foot and shin “went to ‘sleep’ and was still that way Saturday am.” Ganahl said she called the doctor again and was told to bring her daughter to Children’s Hospital Colorado Anschutz Medical Campus.

“She had tick paralysis — it was only caught because of the great docs (most CU School of Medicine) that recognized the similarities to two other cases in recent weeks there (it’s extremely rare so it was very abnormal to see 3 cases in 3 weeks.),” Ganahl posted, in part, on Facebook. “It was a terrifying 12 hours as we waited to see if they were able to remove the tiny bit of tick left in her producing the toxin had been cleaned out of the wound (they didn’t see it). The only fix is to get it out or things get very bad. She is ok! Other then never wanting to go into the woods again.”

Tick paralysis is a rare disease thought to be caused by a toxin in tick saliva, according to the Centers for Disease Control and Prevention (CDC). The symptoms can include acute, ascending, flaccid paralysis that is often confused with other neurologic disorders or diseases such as Guillain-Barre or botulism. Symptoms typically resolve within 24 hours of removing the tick.

Simon LV, McKinney WP. Tick Paralysis. 2019 Mar 3. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from

Tick paralysis is an uncommon, noninfectious, neurologic syndrome characterized by acute ataxia progressing to ascending paralysis. It is caused by the salivary neurotoxin of several species of tick. Clinical findings are similar to and often confused with Guillain-Barre syndrome. Most human cases of tick paralysis occur in North America and Australia. If recognized early and treated promptly, complete recovery is expected with tick removal and supportive care alone. Untreated, it can advance to respiratory failure and death. It is important for healthcare workers to be familiar with this relatively rare but readily treatable cause of acute motor weakness and to maintain a high index of suspicion to avoid delays in diagnosis and treatment. Tick paralysis should be considered in all cases of acute ataxia, especially in children.

Borawski K, Pancewicz S, Czupryna P, Zajkowska J, Moniuszko-Malinowska A. Tick paralysis. Przegl Epidemiol. 2018;72(1):17-24.

Tick paralysis is caused by neurotoxins secreted by adult female ticks, primarily in North America and on the east coast of Australia. Sporadic illness is also recorded in Europe and Africa. In the European countries, including Poland, there are 6 species of ticks capable of causing tick paralysis. The disease occurs in people of all ages, but is most commonly diagnosed in children under 8 years of age. Paralysis can take different forms - from rare isolated cranial nerve infections to quadriplegia and respiratory muscles paralysis. After the tick remove, the symptoms resolve spontaneously. In severe cases with paralysis of respiratory muscles, when there is no possibility of mechanical ventilation, the disease may lead to death.

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