A 35-year-old woman visited our hospital on January 16th, 2000, because she had felt pain on her right temporal scalp during trip in Australia, and noticed eruption at the site when she came back to Japan. Since a tick clung the scalp, we resected it together with surrounding normal skin, and made a diagnosis of tick bite. The tick was identified as Ixodes holocyclus which lives only in Australia and has strong neurotoxin in the salivary gland. Two days after the resection, edema and erythema around the tick bite lesion expanded to the right upper face, and the right facial palsy became apparent. We diagnosed it as tick paralysis. Since paralysis commonly worsens between 24 and 48hours after tick removal, it must be carefully observed for this period. We treated her with antibiotics by way of precaution for Lyme disease that is also caused by a tick bite. She completely recovered from her facial palsy in one month.
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