Tick paralysis in three children. The diversity of neurologic presentations

Reviewed are 3 cases of tick paralysis in children each with a different presentation. One child presented with an ascending flaccid weakness, another with weakness and cerebellar signs, and a third with pure cerebellar signs. Ixodes scapularis, the black-legged deer tick, was the offending tick in Case 3 and apparently has not been previously reported to cause paralysis in humans. Because of the potential for a fatal outcome, it is imperative to consider tick paralysis in any child with an ascending flaccid weakness or acute ataxia.