Occasionally, paralysis is localised, eg Bell's palsy. Tick envenomation should be considered in the differential diagnosis of progressive paralysis in all patients who have been in tick-infested areas. Scorpions are distributed throughout Australia, tending to be larger in the warmer northern areas. On a world scale, Australian scorpions are relatively innocuous, with very few deaths reliably documented as related to scorpion stings. Local pain and swelling are the major clinical problems following Australian scorpion stings.
First aid consists of the application of iced water and analgesia if required.
The scorpions of central and south America and Africa are much more dangerous, with thousands of fatalities and serious illnesses occurring every year in these areas in relation to scorpion envenomation. Centipedes are found throughout Australia, and the rest of the world, and are common in urban gardens. Bites may be painful, especially those inflicted by the larger northern species. The venom is usually associated with only local effects, but systemic illness, and even death, have been reported, although no fatalities have been recorded in Australia. No specific first aid treatment is recommended beyond the application of ice water or packs for local symptom relief.