Hard- and soft-bodied female ticks are thought to produce a neurotoxin capable of causing paralysis in children. Ticks attach to the skin to feed on blood. It is during this feeding process that the toxin enters the bloodstream.

The resulting paralysis is ascending (starting in the lower body and moving up) and is similar to that seen in Guillain-Barre syndrome and opposite that seen in botulism and paralytic shellfish poisoning (descending).

Affected children develop an unsteady gait (ataxia) followed several days later by lower extremity weakness that gradually moves up to involve the upper limbs. Paralysis may cause loss of respiratory ability and the patient may require a ventilator.

• history of exposure to ticks such as camping, a tick-infested area, dogs or other animals
• finding a tick attached at the back of the neck at the hairline
• unsteady jerky body movements and gait (ataxia)
• muscle weakness beginning in the lower extremities and progressing upwards
• breathing difficulties

• respiratory failure

Insect repellents and protective clothing when out in tick-infested areas will help prevent attachment of ticks. A thorough search of the skin for ticks following an outing and removal of any found will prevent tick paralysis.

As a rule, if children are discovered to have ticks, it is a good idea to write the information down and keep it for several months. Many tick-borne diseases do not show symptoms immediately, and the incident may be forgotten by the time a child becomes ill with a tick-borne disease.