Engin A, Elaldi N, Bolayir E, Dokmetas I, Bakir M
Department of Infectious Diseases, Cumhuriyet University School of Medicine, Sivas, Turkey.
Emerg Med J. 2006 Jul;23(7):e42. doi: 10.1136/emj.2006.034835.
Tick paralysis is a disease that occurs worldwide. It is a relatively rare but potentially fatal condition. The only way to establish the diagnosis is to carefully search for the tick paralysis. It is caused by a neurotoxin secreted by engorged female ticks. Tick paralysis generally begins in the lower extremities and ascends symmetrically to involve the trunk, upper extremities and head within a few hours. Although early-onset prominent bulbar palsy and isolated facial weakness without generalised paralysis are rare, there is no report in the English literature concerning isolated, reversible involvement of the upper trunk of brachial plexus caused by tick bite. We report a case of isolated, reversible involvement of the upper trunk of brachial plexus as a variant of tick paralysis. Diagnosis was confirmed with needle electromyography and nerve conduction examination. Within 2 weeks, the patient was fully recovered. The purpose of presenting this case is to remind clinicians that tick paralysis should be considered even in cases with atypical neurological findings admitted to the emergency department.
蜱瘫痪是一种在全球范围内都有发生的疾病。它相对罕见，但可能致命。确立诊断的唯一方法是仔细查找蜱瘫痪。它由饱血雌蜱分泌的神经毒素引起。蜱瘫痪通常始于下肢，并在数小时内对称向上蔓延至躯干、上肢和头部。虽然早期突出的延髓麻痹和无全身性麻痹的孤立性面部无力很少见，但英文文献中尚无关于蜱叮咬导致臂丛上干孤立性、可逆性受累的报道。我们报告一例臂丛上干孤立性、可逆性受累作为蜱瘫痪变异型的病例。通过针极肌电图和神经传导检查确诊。两周内，患者完全康复。展示此病例的目的是提醒临床医生，即使是急诊科收治的具有非典型神经学表现的病例，也应考虑蜱瘫痪。
