07:54am Thursday 27 February 2020

Albany Med Physician Identifies Rare Case of Tick-Associated Paralysis

After a brief clinical examination and a review of numerous medical tests that failed to identify the condition, Karen Powers, M.D., assistant professor of pediatric neurology, asked to check the girl’s hair, where she found the root of the problem:  a dog tick that can cause paralysis and even death, but is rarely found in the northeast.

Dr. Powers, working with Albany Med pediatric hospitalist Sara Horstmann, M.D., simply removed the tick with a pair of tweezers.  Within hours, the patient, Jenna Tomlins, who had come to Albany Med from Hopewell Junction, had completely recovered, and will have no lasting impact from the incident. 

The last documented case of this kind of tick paralysis in the northeast was in 1998 and only 50 cases of tick paralysis were documented in the United States between 1946 and 2006, according to a study published in the January 2010 issue of the American Journal of Medical Toxicology.

“We were truly fortunate to be able to quickly identify the source of the problem, and to bring this girl back to normal in such a short time without needing to put her through uncomfortable and invasive tests and procedures,” Dr. Powers said. 

She said that while cases like this were more common in Virginia where she had completed a fellowship in pediatric neurology, that they were still extremely rare.  Failure to find and remove the tick quickly would have caused expensive and unnecessary testing and ineffective treatment efforts, and may have led to respiratory failure.

“While we were fortunate that Dr. Powers had the experience to diagnose Jenna’s condition so quickly, if gone undetected, this condition could have had dire consequences if the tick was not removed when it was,” said Rachel Tomlins, Jenna’s mother. “I hope that Jenna’s experience can serve as an educational opportunity to other parents to be vigilant about preventing and checking for ticks.”

Roberto Santos, M.D., assistant professor of pediatric infectious disease at Albany Medical Center, said that the condition in this case differs from the infection carried by ticks more commonly found in the northeast. Rather than spreading diseases after having been infected, as is done with deer ticks found in the northeast, the American dog tick, after engorgement from prolonged attachment and feeding transmits neurotoxins that may cause paralysis. 

Dr. Santos said that in tick-infested areas, the best protection is to avoid contact with soil, leaf litter and vegetation. Some ways to protect against ticks include: 

• Wearing light-colored clothing with a tight weave to spot ticks easily.
• Wearing enclosed shoes, long pants and a long-sleeved shirt. Tuck pant legs into socks or boots and shirt into pants.
• Checking clothes and any exposed skin frequently for ticks while outdoors.
• Using insect repellent.
• Staying on cleared, well-traveled trails. Walk in the center of trails. Avoid dense woods and bushy areas.
• Keeping long hair tied back, especially when gardening.
• Bathing/showering as soon as possible after going indoors (preferably within two hours) to wash off and more easily find ticks that may be on you.
• Conducting a final, full-body tick check at the end of the day (including children and pets), and removing ticks promptly.

According to the State Department of Health, the three most common ticks in New York are the deer (black-legged) tick, the American dog tick and the lone star tick. Only deer ticks carry the bacterium that causes Lyme disease. Young deer ticks, called nymphs, are brown and the size of poppy seeds. Adult female deer ticks are red and black, while males are black. Adult deer ticks are about the size of a sesame seed.

American dog ticks can carry the bacterium that causes Rocky Mountain spotted fever. Dog ticks are reddish-brown and larger than deer ticks. Deer and dog ticks are most active during the spring, early summer and fall.  Lone star ticks are becoming more common in New York State. Adult female lone star ticks, which can cause rashes, have a white dot on their back and are similar in size to deer ticks. They are most active from April through July.

Albany Medical Center, northeastern New York’s only academic health sciences center, is one of the largest private employers in the Capital Region. It incorporates the 651-bed Albany Medical Center Hospital, which offers the widest range of medical and surgical services in the region, and the Albany Medical College, which trains the next generation of doctors, scientists and other healthcare professionals,  and which also includes a biomedical research enterprise and the region’s largest physicians practice with 325 doctors. Albany Medical Center works with dozens of community partners to improve the region’s health and quality of life. For more information: www.amc.edu or www.facebook.com/albanymedicalcenter.


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