What clinical manifestations are associated with Lyme neuroborreliosis?

Lyme neuroborreliosis, a neurological manifestation of Lyme disease caused by the Borrelia burgdorferi bacterium, typically presents with a variety of symptoms that affect the central nervous system. One of the hallmark features of this condition includes neurologic symptoms such as arthralgia (joint pain), dysmetria (a lack of coordination characterized by the inability to judge distances), and new onset gait abnormalities. These manifestations indicate that the infection is affecting the nervous system, particularly pathways involved in motor control and sensory perception.

The presence of arthralgia suggests inflammation and potential damage in the joints, while dysmetria and gait abnormalities can imply issues with coordination, which is often a result of neuroinflammation or direct effects of the bacterium on the nervous system. Together, these symptoms indicate that Lyme disease has progressed to a point where neurological involvement is significant.

In contrast, the other options describe manifestations typically associated with different diseases or infection stages. Severe headaches and neck stiffness are more suggestive of meningitis or other intracranial processes, fever and rash are often seen in the early stages of Lyme disease but not specifically in neuroborreliosis, and respiratory distress and cough would not typically be associated with Lyme neuroborreliosis