Neurological manifestations associated with monkeypox infection Monkeypox Neurological Disease encephalitis cerebrospinal pediatric neuroinflammatory IDAdvance UNIRIO_Oficial
By Dr. Liji Thomas, MDSep 5 2022Reviewed by Benedette Cuffari, M.Sc. As the coronavirus disease 2019 transitions to endemic disease, the widespread transmission of the monkeypox virus has become a new threat to public health.
Introduction Like smallpox, monkeypox is mainly a disease of the skin. However, unlike smallpox, which has a 30-40% mortality rate, monkeypox infection appears to resolve spontaneously within three to four weeks of symptom onset in almost all patients. The current outbreak is caused by a less virulent monkeypox strain; however, it continues to spread rapidly.
Neurological disorders associated with monkeypox The most common neurological complications of monkeypox infection include headache and muscle aches, which have been reported in about half of infected patients. Additional neurological symptoms that have been reported include encephalitis, seizures, dizziness, fatigue, vision alterations, photophobia, pain, anxiety, and depression.
CSF changes in viral encephalitis The CSF in viral encephalitis exhibits an increase in cell variety, mainly mononuclear cells at 10–200 cells/µl; however, normal cell counts of less than 5 cells/µl may also be present. The presence of specific monkeypox immunoglobulin M in serum or CSF is also a useful diagnostic tool, as it is evidence of antibodies of intrathecal origin. This is particularly helpful in diagnosing this type of encephalitis during later stages of the disease when PCR is often negative.Smallpox disease and vaccination have also been associated with encephalitis, with vaccination being immune-mediated acute disseminated encephalomyelitis .
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