Ascending Paralysis – Differential Diagnosis From Peds EM Morsels

The diagnoses in Dr. Fox’s list below are a very big deal because any one of them if missed can lead to death from ventilatory failure!

The following is an excerpt from Dr. Sean Fox‘s post on Tick Paralysis PUBLISHED JUNE 20, 2014 · UPDATED JULY 7, 2014:

Other Diagnoses Often Confused with Tick Paralysis

Naturally, evaluating a patient who presents with acute ascending weakness with hyporeflexia will generate concern for the following, and Tick Paralysis is important to consider as well.  When you are considering any of these conditions, you should look closely for any attached ticks and ask about potential exposure.  22% of cases in the USA were initially misdiagnosed and the mean time for correct diagnosis was >2 days.

  • Botulism
  • Guillain-Barre Syndrome
  • Myasthenia gravis
  • Lambert-Eaton syndrome
  • Diptheria
  • Poliomyelitis
  • Transverse myelitis
  • Periodic paralysis
  • Spinal Cord Compression
  • Heavy metal poisoning
  • Organophosphate poisoning
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