Neurological complications in patients with monkeypox: a literature review

Abstract

Introduction. Monkeypox became a new health emergency after a new outbreak appeared in unusual endemic places of the disease, affecting five continents with approximately 16,836 cases, and occurring mostly in men who have sex with men. The new means of transmission is sexual contact. This zoonosis may present rare neurological complications including encephalitis and meningitis. Objective. To develop a bibliographic review of the scientific literature of the last five years on monkeypox as a new worldwide health emergency that provides relevant information for the clinical description of the neurological complications associated with it, favoring its diagnosis, treatment, prognosis, and prevention. Methodology. A bibliographic review of the scientific literature was developed considering articles published, during the last five years, in indexed journals visible in databases of regional and worldwide coverage such as Scopus, WOS, Taylor and Francis and PubMed on neurological complications attributable to monkeypox considering its clinical description to favor diagnosis, treatment, prognosis and effective prevention. The language selected was English and Spanish. Results. The bibliographic review of the literature showed 40 potentially eligible articles, 37 were selected that addressed the aspects under study, which allowed clarification of the clinical expression, complications, positive elements for diagnosis, therapeutic options, and prognosis in endemic and epidemic conditions. Special consideration was given to vaccination alternatives and antiviral prophylaxis. Conclusion. The neurological complications of monkeypox virus infection, although sporadic and infrequent, can cause serious conditions such as encephalitis and meningitis that require early diagnosis and timely treatment considering the efficacy of the arsenal of available antiviral drugs. Prevention of the disease is an essential element in clinical epidemiological control and there are vaccines and antivirals under evaluation that constitute viable alternatives.