Tick Paralysis With Persistent Weakness and Electromyographic Abnormalities

Abstract

• A 3-year-old boy had tick paralysis characterized by ataxia, weakness in the distal portions of the extremities, and hyporeflexia. Unlike most patients with this condition, his weakness receded extremely slowly during a period of months. In addition to the typical reduction in amplitude of motor responses, there were striking electromyographic abnormalities that, to our knowledge, have not previously been reported in tick paralysis. The early appearance and presistence of fibrillation potentials suggested a structural lesion of distal motor axons.