Vedanarayanan V, Sorey W H, Subramony S H
Professor of Pediatrics and Associate Professor of Neurology, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.
Semin Neurol. 2004 Jun;24(2):181-4. doi: 10.1055/s-2004-830905.
Tick paralysis results from inoculation of a toxin from tick salivary glands during a blood meal. It is a relatively uncommon neuromuscular disease with a higher prevalence among young girls, although older men who get exposed to ticks may also be affected. It typically presents as an acute ascending paralysis occurring a few days after tick attachment and may result in respiratory failure and death. Patients may report minor sensory symptoms but constitutional signs are usually absent. Deep tendon reflexes are usually hypoactive or absent and ophthalmoplegia and bulbar palsy can occur. Children may be ataxic. Electromyographic studies usually show a variable reduction in the amplitude of compound muscle action potentials but no abnormalities of repetitive nerve stimulation studies. These appear to result from a failure of acetylcholine release at the motor nerve terminal level. There may be subtle abnormalities of motor nerve conduction velocity and sensory action potentials. Removal of the tick results in the very rapid reversal of clinical and physiologic deficits, quicker with North American ticks than with the Ixodes species seen in Australia.
蜱瘫痪是在蜱虫吸血过程中，其唾液腺毒素接种所致。这是一种相对罕见的神经肌肉疾病，在年轻女孩中患病率较高，不过接触蜱虫的老年男性也可能受到影响。其典型表现为蜱虫附着数天后出现的急性上行性瘫痪，可能导致呼吸衰竭和死亡。患者可能会报告轻微的感觉症状，但通常没有全身症状。深腱反射通常减弱或消失，可出现眼肌麻痹和延髓麻痹。儿童可能会出现共济失调。肌电图研究通常显示复合肌肉动作电位幅度有不同程度降低，但重复神经刺激研究无异常。这些似乎是由于运动神经末梢水平乙酰胆碱释放失败所致。运动神经传导速度和感觉动作电位可能存在细微异常。去除蜱虫后，临床和生理缺陷会很快逆转，北美蜱虫导致的逆转比澳大利亚所见的硬蜱属蜱虫更快。
