Which stage of Lyme disease includes neurological symptoms?

The stage of Lyme disease that includes neurological symptoms is late disseminated Lyme disease. This stage occurs weeks to months after the initial infection and is characterized by the spread of the Borrelia burgdorferi bacteria to various body systems, including the central nervous system. Neurological manifestations during this stage can include conditions such as meningitis, cranial nerve palsies, and radiculopathy among others.

In the earlier stages, notably early localized and early disseminated, patients may experience symptoms such as erythema migrans (a characteristic rash) and systemic signs like fatigue, fever, and muscle aches. While early disseminated Lyme can involve some system-wide symptoms and occasionally neurological involvement, it does not commonly present the range of neurological manifestations seen in the late disseminated phase. The acute phase, on the other hand, typically includes the very early symptoms but not the advanced complications associated with neurological involvement.

Thus, it is the late disseminated stage that firmly establishes neurological symptoms as a key feature, highlighting the need for timely diagnosis and treatment to prevent progression of the disease and associated complications.