Question: What is the classic presentation of tick paralysis?
Answer: According to the cited reference, “The classic presentation is that of an acute symmetric ascending flaccid paralysis that evolves over hours to days, sometimes preceded by prodromal symptoms, including paresthesias, restlessness, irritability, fatigue, and myalgias. These symptoms are followed hours later by flaccid weakness that generally begins in the lower extremities. Fever is absent. The deep tendon reflexes are diminished or absent. If the tick continues to feed, the weakness ascends to the upper extremities over the ensuing 12 to 24 hours. Finally the respiratory muscles fail. (Edlow JA and McGillicuddy DC. Tick paralysis. 2008 Infect Dis Clin No Amer. 22:397-413)
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