Video:Tick paralysis
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Description
Tick paralysis is a neurological condition that begins with tiredness, and progresses to poor ability to walk and muscle weakness as a result of certain tick bites.[1] Weakness starts in the legs and moves up the body.[1]Tick paralysis is rare.[2] Cases, when they do occur, are most frequent in North America and Australia.[1] Children are more commonly affected than adults.[1] The condition was first described in the 1800s.[1]
Presentation
Onset of symptoms requires the tick to be attached for about a week. Symptoms begin with weakness in both legs that progresses to paralysis. The paralysis ascends to the trunk, arms, and head within hours and may lead to respiratory failure and death. The disease can present as acute ataxia without muscle weakness.[1][3][4]
Cause
The two ticks most commonly associated with North American tick paralysis are the Rocky Mountain wood tick (Dermacentor andersoni) and the American dog tick (Dermacentor variabilis).[5]However, to date, 43 tick species have been implicated in human disease around the world.[5]
Pathogenesis
Tick paralysis is believed to be due to toxins found in the tick's saliva that enter the bloodstream while the tick is feeding.Tick paralysis occurs when an engorged and gravid female tick produces a neurotoxin in its salivary glands and transmits it to its host during feeding. Experiments have indicated that the greatest amount of toxin is produced at about one weeks time of attachment.[6][7][8]
Diagnosis
Diagnosis is based on symptoms and upon finding an embedded tick, usually on the scalp.In the absence of a tick.[9][1]Electromyographic (EMG) studies usually show a variable reduction in the amplitude of compound muscle action potentials, but no abnormalities of repetitive nerve stimulation studies.[10][11]
Differential diagnosis
In terms of the differential diagnosis for Tick paralysis we find the following should be considered:Guillain-Barre syndrome, botulism, Myasthenia gravis and poliomyelitis.[1]
Prevention
Individuals should take precautions when entering tick-infested areas, particularly in the spring and summer months. Preventive measures include avoiding trails that are overgrown with bushy vegetation, wearing light-coloured clothes that allow one to see the ticks more easily, and wearing long pants and closed-toe shoes. Tick repellents containing DEET are only marginally effective and can be applied to skin or clothing. [1][12][13]
Treatment
Removal of the tick usually results in resolution of symptoms within several hours to days. The tick is best removed by grasping it as close to the skin as possible and pulling in a firm steady manner. [1][14] In the case of Australian Ixodes holocyclus tick, after the tick is removed paralysis may worsen which would therefore need observation for respiratory compromise.If breathing is impaired due to the tick bite, oxygen therapy may be needed[15][1]
Epidemiology
In terms of the epidemiology we find that batches of cases have been encountered in several countries. It has been identified in Argentina, Canada, and in many regions of the United States.[1]Although tick paralysis is of concern in domestic animals and livestock in the United States, human cases are rare and usually occur in very young children.[16]
History
In terms of the historical aspect of tick paralysis we find that the first documented record was in 1824, by explorers Hamilton Hume and William Hovell that took notice of ticks biting humans during their journey from Lake George and Port Phillip.[17]
References
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 Simon, LV; West, B; McKinney, WP (January 2022). "Tick Paralysis". StatPearls. PMID 29262244.
- ↑ "Tick Paralysis - Injuries; Poisoning". Merck Manuals Professional Edition. Archived from the original on 30 October 2021. Retrieved 13 July 2022.
- ↑ "Tick paralysis: MedlinePlus Medical Encyclopedia". medlineplus.gov. Archived from the original on 27 September 2023. Retrieved 2 July 2024.
- ↑ Edlow, Jonathan A.; McGillicuddy, Daniel C. (September 2008). "Tick Paralysis". Infectious Disease Clinics of North America. 22 (3): 397–413. doi:10.1016/j.idc.2008.03.005. PMID 18755381. Archived from the original on 2024-04-24. Retrieved 2024-07-05.
- ↑ 5.0 5.1 Gothe R, Kunze K, Hoogstraal H (1979). "The mechanisms of pathogenicity in the tick paralyses". J Med Entomol. 16 (5): 357–69. doi:10.1093/jmedent/16.5.357. PMID 232161.
- ↑ Pienaar, Ronel; Neitz, Albert W. H.; Mans, Ben J. (14 May 2018). "Tick Paralysis: Solving an Enigma". Veterinary Sciences. 5 (2): 53. doi:10.3390/vetsci5020053. ISSN 2306-7381. PMC 6024606. PMID 29757990.
- ↑ Murnaghan, Maurice F. (12 February 1960). "Site and Mechanism of Tick Paralysis". Science. 131 (3398): 418–419. Bibcode:1960Sci...131..418M. doi:10.1126/science.131.3398.418. ISSN 0036-8075. PMID 14425361. Archived from the original on 9 July 2024. Retrieved 7 July 2024.
- ↑ Drutz, Jan E. (1 January 2009). "CHAPTER 241 - ARTHROPODS". Feigin and Cherry's Textbook of Pediatric Infectious Diseases (Sixth ed.). W.B. Saunders. pp. 3033–3039. ISBN 978-1-4160-4044-6. Archived from the original on 9 July 2024. Retrieved 7 July 2024.
- ↑ Diaz, James Henry (March 2010). "A 60-year meta-analysis of tick paralysis in the United States: a predictable, preventable, and often misdiagnosed poisoning". Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology. 6 (1): 15–21. doi:10.1007/s13181-010-0028-3. ISSN 1556-9039. PMC 3550436. PMID 20186584.
- ↑ Lin, Jenny; Verma, Sumit (June 2016). "Electrodiagnostic Abnormalities in Tick Paralysis: A Case Report and Review of Literature". Journal of Clinical Neuromuscular Disease. 17 (4): 215–219. doi:10.1097/CND.0000000000000103. ISSN 1537-1611. PMID 27224437. Archived from the original on 2024-07-12. Retrieved 2024-07-10.
- ↑ Vedanarayanan, V.; Sorey, W. H.; Subramony, S. H. (June 2004). "Tick Paralysis". Seminars in Neurology. 24 (2): 181–184. doi:10.1055/s-2004-830905. ISSN 0271-8235. Archived from the original on 2024-07-23. Retrieved 2024-07-17.
- ↑ "Preventing Tick Bites | Ticks | CDC". web.archive.org. 2 July 2024. Retrieved 23 November 2024.
- ↑ Masina, S; Broady, K.W (April 1999). "Tick paralysis: development of a vaccine". International Journal for Parasitology. 29 (4): 535–541. doi:10.1016/S0020-7519(99)00006-5. PMID 10428629. Archived from the original on 2024-04-15. Retrieved 2024-07-11.
- ↑ Needham GR (1985). "Evaluation of five popular methods for tick removal". Pediatrics. 75 (6): 997–1002. doi:10.1542/peds.75.6.997. PMID 4000801. S2CID 23208238.
- ↑ "Tick Paralysis - Tick Paralysis". Merck Manual Professional Edition. Archived from the original on 8 December 2023. Retrieved 11 July 2024.
- ↑ Diaz, James H. (November 2015). "A Comparative Meta-Analysis of Tick Paralysis in the United States and Australia". Clinical Toxicology (Philadelphia, Pa.). 53 (9): 874–883. doi:10.3109/15563650.2015.1085999. ISSN 1556-9519. PMID 26359765. Archived from the original on 4 July 2024. Retrieved 4 July 2024.
- ↑ Grattan-Smith, P. (1 November 1997). "Clinical and neurophysiological features of tick paralysis". Brain. 120 (11): 1975–1987. doi:10.1093/brain/120.11.1975. Retrieved 23 November 2024.