Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, 02115, USA,
Curr Treat Options Neurol. 2010 May;12(3):167-77. doi: 10.1007/s11940-010-0068-7.
Tick paralysis is a toxin-mediated cause of acute flaccid paralysis. Most practitioners will go through their entire career without ever encountering a case. An important veterinary disease, tick paralysis is rare in humans. Although it has certain geographical proclivities, it exists worldwide. Although it tends to occur in young girls, it can occur in any age group. Due to its rarity, doctors often forget to consider tick paralysis in the differential diagnosis of the weak patient. Therefore it is perhaps not surprising that the literature is full of cases in which a mother stroking her child's head or an alert nurse bathing her patient made the diagnosis serendipitously.Physicians should consider tick paralysis in any patient with an acute flaccid paralysis. As a general rule, aimed more towards patient safety than the likelihood of making a correct diagnosis, never definitively diagnose Guillain-Barré syndrome without first searching the entire body for a tick. The treatment of tick paralysis is among the simplest and most gratifying in all of medicine. Tick removal results in rapid improvement of all symptoms. Some patients may require mechanical ventilation and support in an intensive care unit as the toxin clears. Since tick paralysis is toxin-mediated and not caused by an infectious agent, antimicrobials are not indicated. Finally, prevention of tick paralysis, as with most tick-borne diseases, involves changing behavior to avoid tick exposure and performing frequent tick checks to remove them if they have already attached.
蜱瘫痪是一种由毒素介导的急性弛缓性瘫痪的病因。大多数医生在整个职业生涯中都不会遇到一例。蜱瘫痪是一种重要的兽医疾病，在人类中很少见。尽管它有一定的地理倾向，但它在世界范围内都存在。尽管它倾向于发生在年轻女孩身上，但它可以发生在任何年龄组。由于其罕见性，医生常常在虚弱患者的鉴别诊断中忘记考虑蜱瘫痪。因此，文献中充满了这样的病例也就不足为奇了，母亲抚摸孩子的头或警觉的护士给病人洗澡，偶然做出了诊断。医生应该在任何患有急性弛缓性瘫痪的患者中考虑蜱瘫痪。一般来说，这更多是为了患者的安全，而不是为了做出正确诊断的可能性，在没有首先全身寻找蜱之前，切勿明确诊断为格林-巴利综合征。蜱瘫痪的治疗是所有医学中最简单、最令人满意的治疗方法之一。蜱虫的清除会迅速改善所有症状。随着毒素的清除，一些患者可能需要在重症监护病房进行机械通气和支持。由于蜱瘫痪是由毒素介导的，而不是由感染因子引起的，因此不需要使用抗生素。最后，预防蜱瘫痪，就像大多数蜱传疾病一样，涉及改变行为以避免蜱虫暴露，并经常进行蜱虫检查以去除已经附着的蜱虫。
