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A 4-year-old girl presented to the emergency department as a stroke alert with acute onset ataxia and leg weakness. She experienced repeated falls and inability to move her legs. Her neurologic examination revealed ataxia, bilateral distal predominant weakness, and loss of reflexes. She underwent brain MRI which identified a tick on the right occiput (Figure 1). The patient decompensated and was sent to the pediatric intensive care unit where the tick was carefully removed (Figure 2). She fully recovered 4 days later.
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Submitted and editor reviewed. The handling editor was Editor-in-Chief José G. Merino, MD, MPhil, FAHA, FAAN.
- Received June 27, 2022.
- Accepted in final form August 12, 2022.
- © 2022 American Academy of Neurology
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