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Case Reports in Neurological Medicine
Volume 2019, Article ID 3934696, 3 pages
https://doi.org/10.1155/2019/3934696
Case Report

A Case of Tick-Borne Paralysis in a Traveling Patient

University of California, Riverside, School of Medicine, USA

Correspondence should be addressed to Kevin Ha; ude.rcu.hcsdem@ah.nivek

Received 20 March 2019; Accepted 12 June 2019; Published 27 June 2019

Academic Editor: Isabella Laura Simone

Copyright © 2019 Kevin Ha et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Tick paralysis is a neurotoxic tick-borne illness that causes ascending paralysis and may lead to respiratory failure. Patients often undergo extensive testing and prolonged hospitalization before the proper diagnosis is reached. Case Presentation. An 88-year-old man with dementia and dyslipidemia presented with new onset gait instability and was admitted for suspected cerebellar stroke. Exam was significant for the inability to perform tandem gait. Investigations included comprehensive metabolic panel, complete blood count, and noncontrast CT scan; none of them found any evidence of acute pathology. Two days into admission, a tick with surrounding erythema was found on the patient’s left lateral chest during bathing. Dramatic improvement in truncal ataxia was noted following tick extraction. Discussion. Clinical suspicion of tick paralysis is often low due to the rarity of the condition. Although it is imperative to rule out acute cerebral or cerebellar pathology, a thorough skin examination should be performed on admission in any patient with new onset ataxia and ascending paralysis. This can lead to early diagnosis, conservation of resources, and the avoidance of subjecting patients to invasive testing.