ABSTRACT
First recognized in humans in the 19th century A common veterinary problem in Australia and South Africa
Associated primarily with Dermacentor andersoni in the Pacific Northwest and Rocky Mountain regions of the United States, but 43 other species around the world are known to cause the disorder
More common in children with dark hair (which hides the tick)
After the tick has been attached from 4 to 7 days, progressive weakness develops over 2 days, which may progress to full ascending paralysis and areflexia
Pupil reactions, sensorium, and sensation remain intact unless compounded by other illness
Fever is rare The tick should be removed with blunt forceps at the head of the tick after application of petroleum jelly
Symptoms usually begin to resolve within the first 24 hours of removal of the tick
If undiagnosed, mortality rates are 10% to 12% Differential diagnosis includes Guillain-Barré syndrome, myasthenia gravis, botulism, porphyria, and transverse myelitis
