TABLE 1.
Compilation of reports of neuro‐psychiatric manifestations of MPX
| Serial no. | First author | Year of publication | Country | Study design | Sample size | Neurological manifestations | Psychiatric manifestation | Management | Outcome | Reference |
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Dimie Ogoina | 2020 | Nigeria | Retrospective review of case records | 40 |
Headache (19) Myalgia (25) Seizure (1) Encephalitis (3) Photophobia (9) |
Anxiety (11) Depression (11) Suicide (1) |
Symptomatic management and supportive care according to institutional guidelines. |
Deaths (5) Survival (35) |
Ogoina et al., 2020 |
| 2 | Dimie Ogoina | 2019 | Nigeria | Cross‐sectional study | 18 |
Headache (12) Myalgia (5) Pain (5) Photophobia (3) |
Suicide (1) | According to institutional guidelines. |
Deaths (1) Survival (17) |
Ogoina et al., 2019 |
| 3 | Adesola Yinka‐Ogunleye | 2019 | Nigeria | Review of the epidemiological report | 118 |
Headache (61) Myalgia (42) Photophobia (27) |
NA | NA |
Deaths (7) Survival (111) |
Yinka‐Ogunleye et al., 2019 |
| 4 | S. Akar | 2020 | Nigeria | Retrospective review of case records | 165 | Headache (78) | NA | NA |
Deaths (9) Survival (156) |
Akar et al., 2020 |
| 5 | E. E. Eseigbe | 2021 | Nigeria | Case study | 2 | Headache (2) | NA | Both cases were admitted and treated with antibiotics, antihistamines, nonsteroidal anti‐inflammatory drugs, and multivitamins. | Admitted and then discharged after treatment. | Eseigbe et al., 2021 |
| 6 | Christine M. Hughes | 2021 | Democratic Republic of Congo (DRC). | Surveillance study | 134 |
Headache (99) Myalgia (90) Fatigue (115) |
NA | NA | NA | Hughes et al., 2021 |
| 7 | Phillip R. Pittman | 2022 | Democratic Republic of Congo (DRC). | Prospective observational study | 216 |
Headache (49) Myalgia (15) Dizziness (3) Visual deficit (5) Confusion (4) Fatigue (11) |
NA | NA |
Deaths (3) Fetal deaths among admitted pregnant patients (four out of five patients) Survival (213) |
Pittman et al., 2022 |
| 8 | Z. Ježek | 1987 | Zaire/DRC | Surveillance study | 282 |
Encephalitis (1) Coma (1) |
NA | NA |
Deaths (27) Survival (32) |
Jezek et al., 1987 |
| 9 | Boumandouki P | 2007 | Democratic Republic of Congo (DRC). | Surveillance study | 81(8 confirmed) | Myalgia (2) | NA | NA | No deaths | Boumandouki et al., 2007 |
| 10 | E. Kalthan | 2016 | Central African Republic | Descriptive study | 12 | Headache (2) | NA | NA | Fatality (25%), about 67% in children less than 10 years of age | Kalthan et al., 2016 |
| 11 | Gregory D. Huhn | 2005 | United States | Surveillance study | 34 |
Headache (23) Myalgia (19) Seizure (1) Confusion (2) Encephalitis (1) |
NA | Nine patients were hospitalized and treated as inpatients, two of them were a 6‐year‐old girl and a 10‐year‐old girl admitted to intensive care unit. | No deaths | Huhn et al., 2005 |
| 12 | Donita R. Croft | 2007 | United States | Outbreak investigation and cohort study | 19 | Headache (13) | NA | NA | No deaths | Croft et al., 2007 |
| 13 | Kurt D. Reed | 2004 | United States | Outbreak investigation | 11 |
Headache (11) Myalgia (1) |
NA |
Four patients were hospitalized. Nine patients received antibiotics (six received ciprofloxacin, and eight were given doxycycline). One patient received intravenous acyclovir, and two patients received valacyclovir. No patients received vaccinia immune globulin. |
The disease was self‐limiting in all cases | Reed et al., 2004 |
| 14 | Mary G. Reynolds | 2006 | United States | Review of outbreak | 37 |
Headache (32) Myalgia (36) |
NA | NA | NA | Reynolds et al., 2006 |
| 15 | Michael G. Anderson | 2003 | United States | Case report | 1 |
Headache (1) Myalgia (1) Fatigue (1) |
NA |
Intravenous diphenhydramine, lorazepam, and morphine for oropharyngeal pain. Intravenous ampicillin/sulbactam, 200 mg/kg/day divided every 6 h for the retropharyngeal phlegmon. Bacitracin cream was applied on the facial lesions to minimize scarring. |
Discharged after a week of admission. | Anderson et al., 2003 |
| 16 | James J. Sejvar | 2004 | United States | Case series | 3 |
Headache (2) Seizure (1) Altered mental status (1) Delirium/encephalopathy (1) Encephalitis (1) |
NA | One patient required lorazepam, intubation, and intensive care. She was given empiric intravenous ceftriaxone, acyclovir, phenobarbital, and midazolam. |
Two patients did not require inpatient care and their disease remain self‐curing. The third patient, a 6‐year‐old child was discharged after a 16‐day stay in the intensive care unit where she was intubated. |
Sejvar et al., 2004 |
| 17 | Hugh Adler | 2022 | United Kingdom | Retrospective observational study | 7 |
Headache (1) Pain (1) |
Low mood (3) Emotional lability (1) |
Two patients did not require any treatment. A patient with low mood and emotional lability was given a psychological consult Treatment of others varied between symptomatic management and antibiotic administration. |
All seven of them recovered and survived. | Adler et al., 2022 |
| 18 | Lynne A. Learned | 2005 | Republic of Congo (ROC) | Case series | 11 |
Headache (1) Fatigue (2) |
Irritability (2) Distress (4) |
All but three of them required hospitalization. Treatment varied between symptomatic management and hospitalization. |
All 11 of them recovered. | Bolanda et al., 2005 |
| 19 | Mary G. Reynolds | 2013 | Republic of Congo (ROC) | Surveillance study | 2 |
Headache (1) Fatigue (1) |
NA | NA | NA | Reynolds et al., 2013 |