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Neuroimaging in Tick Paralysis: Looking Outside the Box.
Zereen Sarwar1, Aaron Fletcher Osborne2, Chetan Shah3
1Department of Radiology, College of Medicine, University of Florida, Gainesville, FL 32601, USA.
Infectious Disease Reports
|November 22, 2022
Summary
Tick paralysis, a rare neurotoxin-induced condition, can be fatal. This case highlights delayed diagnosis due to subtle tick location, even on normal-appearing MRI scans.
Area of Science:
- Neurology
- Toxicology
- Pediatrics
Background:
- Tick paralysis is a rare, potentially fatal condition caused by tick neurotoxins.
- Diagnosis is often delayed due to subtle presentation and similarity to Guillain-Barre syndrome.
Observation:
- A 4-year-old girl presented with symptoms of tick paralysis.
- The causative tick was not initially found, leading to a 2-day diagnostic delay.
- The tick was retrospectively identified on a brain MRI initially reported as normal.
Findings:
- Tick paralysis diagnosis can be challenging, requiring thorough examination.
- Subtle findings on imaging, like a missed tick on MRI, can occur.
- Prompt identification and removal of the tick are crucial for recovery.
Implications:
- This case underscores the importance of considering tick paralysis in undiagnosed neuromuscular weakness.
- Radiologists and clinicians should be aware of potential subtle tick visibility on neuroimaging.
- Improved diagnostic strategies are needed for this rare but serious condition.
