# A Rare Tick Tale: A Novel Case of the Australian Paralysis Tick Causing Multiple Cranial Neuropathies

## TL;DR

A rare case of a tick bite causing multiple cranial neuropathies and vision issues in Australia is reported, with symptoms improving after treatment.

## Contribution

This paper reports a novel case of tick-bite-induced multiple cranial neuropathies and visual loss not previously documented.

## Key findings

- The patient exhibited tick-bite-associated visual loss and proptosis.
- Symptoms improved after treatment with steroids and doxycycline.
- The authors hypothesize orbital apex inflammation as the cause of the neurological symptoms.

## Abstract

The Australian paralysis tick (Ixodes holocyclus) is found along the east coast of Australia. Tick bites may result in paralysis ranging from muscular weakness to ascending paralysis requiring respiratory support. Ocular complications and facial nerve involvement are rare. We present a rare occurrence of tick-bite-associated visual loss, proptosis, and multiple cranial neuropathies not previously reported in the literature. The tick was removed, and the patient's symptoms improved following treatment with steroids and oral doxycycline. The vision and sensory changes are not explained by the Ixodes toxin; thus, we hypothesize this is related to orbital apex inflammation.