A Case of Tick-Borne Paralysis in a Traveling Patient

Background. Tick paralysis is a neurotoxic tick-borne illness that causes ascending paralysis and may lead to respiratory failure. Patients often undergo extensive testing and prolonged hospitalization before the proper diagnosis is reached. Case Presentation. An 88-year-old man with dementia and dy...

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Main Authors: Kevin Ha, Kathryn Lewis, Vandan Patel, Jennifer Grinceri
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Case Reports in Neurological Medicine
Online Access:http://dx.doi.org/10.1155/2019/3934696
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author Kevin Ha
Kathryn Lewis
Vandan Patel
Jennifer Grinceri
author_facet Kevin Ha
Kathryn Lewis
Vandan Patel
Jennifer Grinceri
author_sort Kevin Ha
collection DOAJ
description Background. Tick paralysis is a neurotoxic tick-borne illness that causes ascending paralysis and may lead to respiratory failure. Patients often undergo extensive testing and prolonged hospitalization before the proper diagnosis is reached. Case Presentation. An 88-year-old man with dementia and dyslipidemia presented with new onset gait instability and was admitted for suspected cerebellar stroke. Exam was significant for the inability to perform tandem gait. Investigations included comprehensive metabolic panel, complete blood count, and noncontrast CT scan; none of them found any evidence of acute pathology. Two days into admission, a tick with surrounding erythema was found on the patient’s left lateral chest during bathing. Dramatic improvement in truncal ataxia was noted following tick extraction. Discussion. Clinical suspicion of tick paralysis is often low due to the rarity of the condition. Although it is imperative to rule out acute cerebral or cerebellar pathology, a thorough skin examination should be performed on admission in any patient with new onset ataxia and ascending paralysis. This can lead to early diagnosis, conservation of resources, and the avoidance of subjecting patients to invasive testing.
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spelling doaj-art-1dd4656d2e834344a8305fa8737693372025-02-03T01:30:37ZengWileyCase Reports in Neurological Medicine2090-66682090-66762019-01-01201910.1155/2019/39346963934696A Case of Tick-Borne Paralysis in a Traveling PatientKevin Ha0Kathryn Lewis1Vandan Patel2Jennifer Grinceri3University of California, Riverside, School of Medicine, USAUniversity of California, Riverside, School of Medicine, USAUniversity of California, Riverside, School of Medicine, USAUniversity of California, Riverside, School of Medicine, USABackground. Tick paralysis is a neurotoxic tick-borne illness that causes ascending paralysis and may lead to respiratory failure. Patients often undergo extensive testing and prolonged hospitalization before the proper diagnosis is reached. Case Presentation. An 88-year-old man with dementia and dyslipidemia presented with new onset gait instability and was admitted for suspected cerebellar stroke. Exam was significant for the inability to perform tandem gait. Investigations included comprehensive metabolic panel, complete blood count, and noncontrast CT scan; none of them found any evidence of acute pathology. Two days into admission, a tick with surrounding erythema was found on the patient’s left lateral chest during bathing. Dramatic improvement in truncal ataxia was noted following tick extraction. Discussion. Clinical suspicion of tick paralysis is often low due to the rarity of the condition. Although it is imperative to rule out acute cerebral or cerebellar pathology, a thorough skin examination should be performed on admission in any patient with new onset ataxia and ascending paralysis. This can lead to early diagnosis, conservation of resources, and the avoidance of subjecting patients to invasive testing.http://dx.doi.org/10.1155/2019/3934696
spellingShingle Kevin Ha
Kathryn Lewis
Vandan Patel
Jennifer Grinceri
A Case of Tick-Borne Paralysis in a Traveling Patient
Case Reports in Neurological Medicine
title A Case of Tick-Borne Paralysis in a Traveling Patient
title_full A Case of Tick-Borne Paralysis in a Traveling Patient
title_fullStr A Case of Tick-Borne Paralysis in a Traveling Patient
title_full_unstemmed A Case of Tick-Borne Paralysis in a Traveling Patient
title_short A Case of Tick-Borne Paralysis in a Traveling Patient
title_sort case of tick borne paralysis in a traveling patient
url http://dx.doi.org/10.1155/2019/3934696
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