“…23,24 Tick paralysis is easily confused with a variety of other conditions (Table 3). 25 Ours is not the first instance in which careful examination with a finetoothed comb led to the correct diagnosis; in other cases, patients were initially thought to have cerebellar ataxia, 26 poliomyelitis, 27,28 or "idiopathic paralysis." 6 In each of these cases, the engorged tick was detected in scalp hair by a nurse using a comb, after extensive clinical evaluation by one or more physicians and hours to days of observation and laboratory testing.…”