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Neurological manifestations of an emerging zoonosis-Human monkeypox virus: A systematic review
Sajjad Ahmed Khan1, Surya Bahadur Parajuli2, Vivek K Rauniyar3
1Birat Medical College Teaching Hospital, Morang, Nepal.
Background:
The last few decades have witnessed an appalling rise in several emerging and re-emerging viral and zoonotic outbreaks. Amongst those emerging zoonosis, one of the diseases which is gaining popularity these days and has been declared as public health emergency of international concern by the world health organization, is human monkeypox virus (HMPX). Proper understanding of the clinical spectrum of the disease is of paramount importance for early diagnosis and treatment. In this review, we aimed to study and quantify the neurological manifestations of HMPX virus infection.
Methods:
Any study, released prior to April 13, 2023, that reported neurological manifestations in patients infected by HMPX virus were reviewed systematically on PubMed, Scopus, Google Scholar, and Cochrane Library using the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analysis) statement.
Results:
Our systematic review included data from 22 eligible studies: 10 cohort studies, 3 cross sectional studies, one retrospective study, 5 case series, and 2 case reports. The most commonly reported neurological manifestations of HMPX were headache (48.84%), myalgia (27.50%), fatigue (17.73%), and photophobia (4.43%). Uncommonly, HMPX can also present with visual deficit (0.57%), seizure (0.34%), encephalitis (0.8%), dizziness (0.34%), encephalomyelitis (0.23%), coma (0.11%), and transverse myelitis (0.11%).
Discussions:
Monkeypox virus usually presents with self-limiting painful rash, lymphadenitis, and fever, complications like secondary skin infection, eye problems and pneumonia can be life threatening, carrying a case fatality rate of 1% to 10%. Neurological manifestations are not uncommon and can further add-on to morbidity and mortality.
Insights
Neurological symptoms like headache and fatigue are common in human monkeypox (HMPX) virus infections. Understanding these neurological effects is crucial for diagnosing and managing this emerging zoonotic disease.
Area of Science:
- Virology
- Neurology
- Public Health
Background:
- Emerging viral and zoonotic outbreaks are increasing globally.
- Human monkeypox virus (HMPX) is a significant public health concern.
- Understanding HMPX clinical spectrum is vital for diagnosis and treatment.
Purpose of the Study:
- To systematically review and quantify the neurological manifestations of HMPX virus infection.
- To provide a comprehensive overview of HMPX-associated neurological symptoms.
Main Methods:
- Systematic review of studies published before April 13, 2023.
- Searches conducted on PubMed, Scopus, Google Scholar, and Cochrane Library.
- Adherence to PRISMA statement for systematic reviews and meta-analyses.
Main Results:
- Data from 22 eligible studies were analyzed.
- Common neurological symptoms include headache (48.84%), myalgia (27.50%), fatigue (17.73%), and photophobia (4.43%).
- Less common manifestations include seizures, encephalitis, encephalomyelitis, and transverse myelitis.
Conclusions:
- Neurological manifestations are frequent in HMPX infections.
- These neurological symptoms can increase disease morbidity and mortality.
- Early recognition of neurological signs is important for patient outcomes.
