Tick Paralysis

Tick paralysis is a flaccid ascending paralysis caused by the bite of certain female ticks, specifically in North

America, Dermacentor andersoni, D. variabilis, D. occidentalis, Amblyomma americanum, and A. maculatum, which are found commonly in areas west of the Rocky Mountains. The toxin producing the disease is presumably excreted in the saliva of the mature female tick during engorgement. Although persons of any age may be affected, small children are particularly likely to become paralyzed. The head and neck are the most common sites of tick attachment, although any part of the body may be involved. There is some indication of an association between the proximity to the brain of the site of attachment and the severity of the disease. The toxin acts either by causing a failure to liberate acetylcholine at the neuromuscular junction or by causing a generalized depression of all excitable tissues, including the neurons of the spinal cord and brain stem. The course of tick paralysis depends on how soon the tick is found and removed. If it is removed before bulbar symptoms begin, improvement occurs within hours and is complete by 1 week. If bulbar symptoms have begun, death often occurs despite intensive therapy. y

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