Background and purpose: Tick paralysis is a relatively rare and fatal disease caused by some species of blood-sucking ticks of Ixodidae family including Ixodes scapularis and Dermacentor andersoni. This disease is characterized by ascending acute flaccid paralysis but could be misdiagnosed with other neurological diseases especially, Guillain-Barré syndrome because of similar clinical presentations. In this review we aimed to introduce tick paralysis to raise awareness on differential diagnosis of tick paralysis with other neuropathies.

Materials and methods: A narrative review study was performed in which data was collected without time and language limits from international electronic databases including: Pub Med, Web of Science, Google Scholar, Elsevier (ScienceDirect, Scopus), Lilacs, and Iranian scientific databases including: Barakatkns, SID, Civilica, Magiran, and Medlib using appropriate keywords.

Results: Tick paralysis mainly affects children (usually girls). The paralysis is caused by toxin in the saliva of hard ticks and if blood feeding is continued for a long time, respiratory failure and probably death may occur. The absolute therapy of tick paralysis is simply removing ticks that are attached to the patient’s body. Improvement in symptoms is usually observed within 24 hours to a few days after removing the tick/s.

Conclusion: Finding the tick/s and symptoms of paralysis are the main characteristics in diagnosis of tick paralysis.  Since the disease is caused by the toxin in tick saliva, therefore, antibiotics are not effective in its treatment. Also, due to frequent misdiagnosis of the disease, awareness of the healthcare providers can play a considerable role in early detection, treatment, preventing additional costs of laboratory examinations, and ultimately prevent death.