What you need to know about monkey pox neurological symptoms?


Story at a glance

  • Monkeypox cases drop in US

  • The CDC released a report this summer on neurological complications in two patients.

  • Symptoms may include headaches and mood disorders.

A new report and paper on monkeypox provide information about neurological complications affecting the brain and how they were treated.

More than 24,000 cases of monkeypox have been reported in the US, according to the Centers for Disease Control and Prevention. The number of cases seems to have peaked, although we are still learning how the disease has spread and affected people.

The CDC reported two acute cases of monkeypox virus (MPXV) in Colorado and DC last summer, in which the patients also had encephalomyelitis, which involves inflammation in the brain and/or spinal cord. For the two patients, neurological symptoms appeared within five and nine days of disease onset. Both patients received oral tecovirimat, a treatment developed for smallpox.

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The mechanism for how the neurological symptoms appear “is unclear, but could be an MPXV invasion of the [central nervous system]or an autoimmune process caused by systemic MPXV infection, the report states.

In a paper published in the journal JAMA Neurology, doctors assess the neurological complications associated with cases of monkeypox and smallpox. They write about the well-known neurological symptoms of monkeypox, including headaches and mood disorders. There is also the possibility of post-vaccination encephalomyelitis, in which there is inflammation in the brain and spinal cord after vaccination.

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Headaches are common with MPXV infections, the paper said. Other symptoms include mood disorders, such as depression and anxiety, and nerve pain, also known as neuropathic pain.

For physicians potentially treating MPXV patients, these new reports may help understand the range of neurological complications their patients may experience. This may include pain management in the form of topical agents, oral medications or nerve blocks, the paper said. “Painful lesions may respond to antiviral treatments; therefore access to them is crucial.”

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“Physicians and health professionals should be aware of the range of potential clinical presentations of MPXV infections and potential treatments,” write the authors of the CDC report. “Suspected cases should be reported to state, tribal, local or territorial health departments to improve understanding of the range of clinical manifestations of MPXV infections and treatment options.”



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