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The toxin-secreting Ixodidae ticks can cause ascending paralysis if allowed to remain attached to the skin for several days. The paralysis is reversible upon removal of the tick. [Merck Manual, p. 2953] Symptoms may resemble those of Guillain-Barre syndrome, botulism, and myasthenia gravis. In one recent case, the patient had ataxia, absent tendon reflexes, drooling, and tachypnea. [MMWR 4/26/96] The reaction occurs after prolonged tick attachment of at least 4-7 days. The onset of ascending paralysis occurs within 24-48 hours. Recovery occurs within 24 hours of tick removal. The American dog tick and Rocky Mountain wood tick cause the disease in North America. Ixodes holocyclus causes a more severe form of the disease in Australia. Often affected are young girls with long hair that hides the tick. [PPID, p. 3277-8]