Objective:

To characterize the neurological manifestations and adverse events related to the monkeypox virus. In an effort to better inform clinicians on the rare but devastating neurological manifestations in human monkeypox.

Background:

The monkeypox virus (MPXV) belongs to the family of orthopoxviruses. MPXV is the causative agent of human monkeypox. Traditionally human monkeypox has been confined to the African continent however a growing number of monkeypox cases have been reported by the Centers of Disease Control (CDC) starting in May 2022. This systematic review aims to characterize the neurological manifestation of human monkeypox.

Design/Methods:

A systematic review was conducted across three databases PubMed/PubMedCentral/MEDLINE, ScienceDirect, and Scopus. The review was conducted in accordance with PRISMA guidelines and was prospectively registered on PROSPERO (Registration ID: CRD42022336088).

Results:

A total of 8 cases are identified describing neurological manifestations secondary to human monkeypox. Five cases of encephalitis are identified and one of conjunctivitis leading to severe vision impairment. Notably, during the current 2022 outbreak two cases of encephalomyelitis have been identified within the United States. Cases involving children are believed to be of greater severity and two deaths were identified.  Most cases were managed with high-dose intravenous methylprednisolone and immunomodulators such as IVIG.

Conclusions:

Although rare, neurological manifestations and secondary neuroinflammatory conditions are possible secondary to human monkeypox. Cases in children are likely to carry greater severity with increased morbidity and mortality. As cases continue to emerge through the 2022 global outbreak clinicians must remain vigilant in monitoring for neurological complications from the monkeypox virus.