Abducens nerve palsy following a tick bite: a case report.

Neuromuscular paralysis caused by salivary proteins of ticks is a well-known complication after tick bites in Australia, North America, and South Africa. Symptoms may include general weakness, difficulty walking, ascending paralysis, and bulbar paralysis with diplopia, culminating in respiratory failure. In Europe, toxin-mediated paralysis has rarely been noted. We report a case of cranial nerve paralysis with delayed onset after a tick bite in northern Germany.