The presence of a tick in combination with a sudden (12-24 hours) appearance of leg weakness and/or respiratory impairment is crucial and diagnostic. The tick may no longer be attached, but a tick “crater” (a small hole surrounded by a slightly raised and inflamed area) might still be detectable in the skin and can confirm the diagnosis. Specific laboratory diagnostic techniques are not available. Procedures that may be helpful include the determination of the PCV and a lateral thoracic radiograph to assess presence and degree of pulmonary oedema, megaesophagus, and potential pneumonia due to aspiration.
Differential diagnosis include botulism, Guillain-Barré syndrome, spinal cord compression, transverse myelitis, encephalomyelitis heavy metal poisoning and some other more rare causes.
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