24 | Tick Paralysis: Easy to treat but easy to miss with Toni Dobson, DNP, FNP-C, ENP-C

24 | Tick Paralysis: Easy to treat but easy to miss with Toni Dobson, DNP, FNP-C, ENP-C

⏱️ Runtime: about 13 minutes

📝 Episode Summary In this conference-series episode, Toni steps into the role of both host and guest to share her AAENP presentation on tick paralysis. It's a rare neurologic presentation in the emergency department and one that ED clinicians often miss. Toni explains why: she had it on her differential, searched the patient for a tick and still missed it.

The episode covers how tick paralysis develops and who's most at risk. Toni walks through a pediatric case of acute-onset ataxia, builds a differential and shows how to tell tick paralysis from Guillain-Barré syndrome (GBS). She also shares a practical ED algorithm that starts with a thorough skin exam.

LINK to algorithm: https://drive.google.com/file/d/1Ld-3mh1m89_dVaFo82CtCS-oqQa3xll7/view?usp=sharing

⏰ Timestamps

00:00 Intro

00:18 Welcome and the AAENP conference series

00:39 Why tick paralysis, and why it gets missed

01:24 What tick paralysis is: the tick, the toxin and the timeline

02:25 Ascending paralysis, mortality and treatment

02:59 Who's at risk

03:23 Why ED clinicians miss it

04:15 The case: a 3-year-old with acute ataxia

05:53 Building the differential

07:19 Tick paralysis vs. GBS

09:31 The ED algorithm 10:14 The skin exam and the flea comb

11:00 After the tick is removed: observe, then discharge or admit

11:32 When symptoms don't improve

12:13 Take-home points

13:05 Disclaimer

⚖️ Disclaimer Any opinions expressed on today's podcast are solely those of the speaker and do not reflect the opinions or policies of any employer or hospital system. In many states, advanced practice providers work collaboratively with physicians. Always consult your physician leader when appropriate. Any cases discussed on this podcast have been de-identified, and details have been changed or omitted to protect patient privacy. Some cases may also represent composites of our clinical experiences, and any resemblance to a specific individual beyond the educational context is unintentional. This podcast was designed for medical education purposes only. Its speakers have made every effort to provide the most current and evidence-based information. However, that should never replace one's own effort to validate current evidence-based practice before implementing a plan of care. Any pathway or algorithm that we may have discussed may not reflect those of your healthcare system. Please be aware that there may be changes based on your geographic location or current employer site. This podcast was not designed in any way to provide medical advice or treatment plans for patients and their families. If you have a medical concern or an emergency, please be seen by a local medical provider or call nine one one for assistance.