Introduction
Ticks or order Ixodida are tiny blood-sucking parasites that are around three to five millimeters in length and have eight legs. A tick bite can infect a normal healthy human being with viruses, bacteria, and protozoans that can cause many diseases. There are many species of ticks, such as black-legged ticks or deer ticks, and lone star ticks. Some of the ticks are brown or reddish brown and, when fed on blood, become prominent and visible. In rare cases, tick bites can cause complications, and one such complication is known as tick paralysis.
What Is Tick Paralysis?
As the name suggests, tick paralysis occurs due to a tick bite and was first described in the 19th century in Australia. Tick paralysis is a noninfectious neurologic syndrome characterized by acute ataxia leading to paralysis. Most of the cases in humans are seen in North America and Australia. It is curable if detected on time. Around 40 species of ticks are associated with tick paralysis; for example, in North America, Dermacentor species of the tick family cause tick paralysis. In almost all cases, paralysis occurs by the bite of a female tick. Tick paralysis is more common in children and is more common in females because the long hair makes the tick escape from being detected early.
What Causes Tick Paralysis?
Tick paralysis is caused by neurotoxin (a synthetic substance that destroys the central nervous system functioning) exposure that is released through the tick's salivary gland during the bite. The neurotoxin that is secreted by the tick in the salivary gland is termed holocyclotoxin. These toxins affect the normal functioning of the nervous system, which causes paralysis of the motor neurons.
What Are the Symptoms of Tick Paralysis?
The symptoms start showing after 3 to 7 days and may vary depending on the species of the tick. Some of the commonly seen symptoms include:
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Acute ataxia (sudden or uncoordinated muscle control that causes difficulty walking and balancing).
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Paralysis starts in the legs and feet that gradually moves upwards.
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Numbness or tingling.
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Muscle pain.
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Tiredness.
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Irritability.
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Difficulty breathing.
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A child may have a mild fever or flu.
How Is Tick Paralysis Diagnosed?
An individual can be exposed to ticks in many ways, like going in the woods for camping, having a dog, or living in a tick-endemic area. Ticks can bite on several body regions and are often attached to armpits and toenails. However, the most common area where ticks are found is on the scalp and hairline. The doctor will ask if the patient has recently been to the woods or if they have a dog and clinically check the scalp or other parts of the body for ticks. Red bumps may be present if the ticks have fallen off the scalp.
What Is the Possible Complication of Tick Paralysis?
Breathing difficulties can lead to respiratory failure. It is a severe complication in which the blood does not have enough oxygen due to infection directly affecting the lungs. It develops slowly and causes extreme tiredness.
How Is Tick Paralysis Managed?
Treatment options include:
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The main treatment is to remove the tick from the scalp or the hairline. Professionally it can be done by using fine forceps to pull out the tick with a steady and gentle upward motion. It should be noted that the mouth or any other part of the tick should not be left. Once all the ticks are removed, it will rapidly reduce the symptoms.
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Prevention is the main factor that can avoid exposure to ticks. While going out or camping, where ticks are easily infested, an individual should wear long pants, hats, and full sleeves shirts. Pants should be tucked in the socks while walking through the grass. If there are dogs at home, proper cleaning and regular visits to a veterinary doctor are recommended.
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Permethrin (an insecticide) should be applied on the clothes as it acts as the ticks repellent.
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In severe cases of Australian Ixodes holocyclus tick bite, the symptoms may worsen after 24 to 48 hours of tick removal. So a proper observation for one or two days for respiratory compromise is suggested.
What Are the Differential Diagnosis of Tick Paralysis?
Differential diagnoses include:
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Guillain Barre Syndrome: It is a rare disorder in which the immune system attacks the nerves due to a respiratory or digestive tract infection. The tick paralysis and Guillain Barre syndrome symptoms are very similar, and often, tick paralysis is confused for this syndrome before a proper diagnosis.
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Botulism: The neurotoxins released by the Ixodes holocyclus (in tick paralysis) have similar clinical findings as botulism. One of the reasons for paralysis can be botulism, a rare condition caused by a toxin affecting the body’s nerves. Clostridium Botulinum bacteria produce the toxin.
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Poliomyelitis: Also known as polio, it is a life threatening condition caused by the poliovirus. It can affect the spinal cord and lead to paralysis.
Conclusion
Ticks are tiny parasites that feed on human blood. In the growing stage, they are not easily visible to the naked eye. In their adult stage, they are visible once they have fed on blood. Tick paralysis is a noninfectious syndrome that can lead to paralysis due to a neurotoxin released by a female tick. It can be easily managed by removing all the ticks from the scalp or other infected areas. Once all the ticks are removed, the symptoms start to fade. There is no need to administer the patient in the hospital unless any complication is involved. It is necessary to keep the surroundings clean and use repellents whenever going out.
