Danise PD Coelho

Conference 2023 Presentation

Project title

Neurological complications of Monkeypox: a literature review

Authors and Affiliations

Danise Paula Dias Coelho1, ,Lidiane Gomes Bandeira2, Bianca Júlia Davide3, Eduardo José D’Oranges Melo Filho4, Djanira Aparecida da Luz Veronez5

1. University of Rio Verde – Campus Aparecida (UniRV), Aparecida de Goiânia-GO, Brazil
2. Federal University of Pernambuco – Campus Agreste, Caruaru-PE, Brazil
3. Pernambuco Faculty of Health (FPS) – Recife-PE, Brazil
4. Pontifical Catholic University of Goiás, Goiânia-GO, Brazil
5. Federal University of Paraná – Curitiba-PR, Brazil

Abstract

Background

Monkeypox disease (MPX) is a zoonosis from central Africa caused by the orthopoxvirus, its neurological manifestations are rare and when manifested, they suggest nonspecific encephalopathy as the most common manifestation and encephalomyelitis as the subpredominant. The study aims is obtain pathophysiological data responsible for the neurological complications of Monkeypox.

Methods

This is an integrative literature review, using the PubMed database, using the descriptors “Monkeypox”; “Neurologic Manifestations”, joined by the Boolean operator “AND”. Resulted in 10 selected articles, of which only 6 were included in the research. The inclusion criteria were: original articles published between 2018 and 2022. The exclusion criteria used were duplicate articles and publications where the proposed topic did not appear to be the main focus.

Results

Neurotropic potential, although rare, is found in humans. Of the neurological presentations of MPX, nonspecific encephalopathy is the most common manifestation of the Central Nervous System, while post-infectious and post-immunization acute disseminated encephalomyelitis (ADEM) represents about 3/4 of the cases. However, even pointing out the emergence of encephalomyelitis as one of the rare neuropathic manifestations, it is still not possible to conclude the pathophysiology associated with the manifestations as clear, nor whether it is the result of direct viral neuroinvasion or a parainfectious autoimmune process. In addition, other symptomatological reports of encephalitis and seizures after MPX, such as nonspecific headache, “neck stiffness”, and mental confusion were present findings. Furthermore, other presentations include psychiatric symptoms such as anxiety and depression, as well as sensory-perceptual disorders such as vision changes, photophobia and dizziness.

Conclusions

Although cases of neurological complications in Monkeypox disease are rare, their occurrences can lead to morbidity and mortality. The correct and early diagnosis of the disease, the use of tools to screen for neuropathies and complementary exams are of unquestionable relevance. However, as it is a recent association, further studies are still required for a better understanding of the pathophysiology of the neurological manifestations associated with this zoonosis.