Department of Neurology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.
Semin Neurol. 2012 Nov;32(5):531-2. doi: 10.1055/s-0033-1334474. Epub 2013 May 15.
Tick paralysis is a rare, but readily treatable condition that if missed can lead to significant morbidity and death. The classic clinical presentation of tick paralysis is the development of an unsteady, ataxic type gait followed by an acute symmetric ascending flaccid paralysis. Symptoms generally begin within 2 to 6 days of tick attachment. If the tick continues to feed, the weakness ascends to the upper extremities over a matter of hours, followed by cranial nerve involvement. Due to the similarity in its presentation, tick paralysis is often misdiagnosed as Guillain-Barré's syndrome, particularly the Miller Fisher's subtype, given its cranial nerve involvement. However, the weakness seen in tick paralysis progresses more quickly than what is generally seen in Guillain-Barré's syndrome and the protein concentration is not elevated in the cerebrospinal fluid. The mainstay of treatment for tick paralysis is tick removal. The time to full neurologic recovery after tick removal is estimated to be around 1.5 days with initial improvement generally within hours.
蜱瘫痪是一种罕见但易于治疗的疾病，如果被忽视可能会导致严重的发病率和死亡率。蜱瘫痪的典型临床表现为不稳定、共济失调型步态，随后出现急性对称弛缓性瘫痪。症状通常在蜱虫附着后 2 至 6 天内开始出现。如果蜱虫继续进食，虚弱会在数小时内上升至上肢，随后累及颅神经。由于蜱瘫痪的表现相似，它经常被误诊为吉兰-巴雷综合征，特别是米勒-费舍尔亚型，因为它涉及颅神经。然而，蜱瘫痪中的虚弱进展比吉兰-巴雷综合征中通常看到的更快，并且脑脊液中的蛋白质浓度没有升高。蜱瘫痪的主要治疗方法是去除蜱虫。去除蜱虫后完全恢复神经功能的时间估计约为 1.5 天，一般在数小时内开始改善。
