{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T20:40:07Z","timestamp":1746391207360,"version":"3.40.4"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>The aims of the study were to identify and to describe cases of pediatric tick paralysis presenting to an emergency department in southern Louisiana during an 11-year period.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We conducted a retrospective chart review of patients aged 0 to 18 years with a diagnostic code of toxic effect of venom, tick-borne viral encephalitis, Guillain-Barr\u00e9 syndrome, acute infective polyneuritis, or abnormality of gait from July 2005 to June 2016. Data were collected on visit month, patient age, race and sex, tick's attachment site, location of tick removal, symptoms and length of symptoms, initial diagnosis, time to appropriate diagnosis, and hospital length of stay.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Nine patients aged 2 to 10 years presented with lower limb weakness and varying degrees of upper extremity ataxia or paralysis, areflexia, dysarthria, diplopia, or petechia. Five cases were accurately and rapidly diagnosed; 4 cases involved a delay in accurate diagnosis. Treatment of the misdiagnosed cases ranged from septic workup to neurologic workup, including magnetic resonance imaging. The tick was discovered by the patients' relative in 4 cases, by a primary care or emergency care physician at another facility in 3 cases, and by 1 of our emergency care physicians in 2 patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The incidence of tick paralysis in southern Louisiana is unknown. However, our case series indicates that it is likely higher than expected. Although most cases in our facility were quickly diagnosed and treated through tick removal, delayed diagnosis results in unnecessary tests, procedures, and medical costs. All of our cases fully recovered after tick removal.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000002572","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T16:20:38Z","timestamp":1638894038000},"page":"589-592","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Tick Paralysis Case Series"],"prefix":"10.1097","volume":"37","author":[{"given":"Kristen","family":"Pontiff","sequence":"first","affiliation":[{"name":"Our Lady of the Lake Children's Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Woodward","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela","family":"McMahon","sequence":"additional","affiliation":[{"name":"Pediatric Residency Program, Our Lady of the Lake Children's Hospital, Baton Rouge, LA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"bib1-20250504","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1212\/WNL.59.7.1088","article-title":"Tick paralysis in children: electrophysiology and possibility of misdiagnosis","volume":"59","year":"2002","journal-title":"Neurology"},{"key":"bib2-20250504","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s13181-010-0028-3","article-title":"A 60-year meta-analysis of tick paralysis in the United States: a predictable, preventable, and often misdiagnosed poisoning","volume":"6","year":"2010","journal-title":"J Med Toxicol"},{"key":"bib3-20250504","first-page":"273","article-title":"Tick paralysis in the United States","volume":"162","year":"2010","journal-title":"J La State Med Soc"},{"key":"bib4-20250504","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.idc.2008.03.005","article-title":"Tick paralysis","volume":"22","year":"2008","journal-title":"Infect Dis Clin North Am"},{"key":"bib5-20250504","first-page":"e91","article-title":"Child neurology: tick paralysis: a diagnosis not to miss","volume":"82","year":"2014","journal-title":"Neurology"},{"key":"bib6-20250504","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1056\/NEJM200001133420204","article-title":"A six-year-old girl with tick paralysis","volume":"342","year":"2000","journal-title":"N Engl J Med"},{"key":"bib7-20250504","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1097\/01.pec.0000181414.18612.24","article-title":"Tick paralysis: atypical presentation, unusual location","volume":"21","year":"2005","journal-title":"Pediatr Emerg Care"},{"key":"bib8-20250504","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s11940-010-0068-7","article-title":"Tick paralysis","volume":"12","year":"2010","journal-title":"Curr Treat Options Neurol"},{"key":"bib9-20250504","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1086\/313502","article-title":"Tick paralysis: 33 human cases in Washington State, 1946\u20131996","volume":"29","year":"1999","journal-title":"Clin Infect Dis"},{"key":"bib10-20250504","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1177\/0883073816643407","article-title":"Acute ataxia in childhood: 11-year experience at a major pediatric neurology referral center","volume":"31","year":"2016","journal-title":"J Child Neurol"},{"journal-title":"Cancer Ther Advisor","key":"bib11-20250504","article-title":"Tick paralysis"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002572","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,4]],"date-time":"2025-05-04T20:03:28Z","timestamp":1746389008000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PEC.0000000000002572"}},"subtitle":["An 11-Year Institutional Case Series"],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":11,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000002572","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"type":"electronic","value":"1535-1815"},{"type":"print","value":"0749-5161"}],"subject":[],"published":{"date-parts":[[2021,12]]}}}