Table 3.

Summary of included studies.

Study:	na:	Country:	Clade/ strain:	Dateb:	Study population:	Neuropsychiatric features:	Other clinical detail:
Ogoina et al. 202013	40	Nigeria	-	09/2017–12/2018	Individuals hospitalised with monkeypox in specific states of Nigeria	Headache 19, myalgia 25, seizure 1, encephalitis 3, photophobia 9, anxiety and depression 11, suicide 1	Those with anxiety and depression required psychological counselling as inpatients
Ogoina et al. 201914	18	Nigeria	-	09/2017–12/2017	Individuals treated at Niger Delta University Teaching Hospital	Headache 12, myalgia 5, pain 5, photophobia 3, suicide 1	Majority expressed fear and anxiety over facing stigma and discrimination from hospital staff
Yinka-Ogunleye et al., 201915	118	Nigeria	West African	09/2017–09/2018	National case surveillance study	Headache 61, myalgia 42, photophobia 27
Akar et al., 202016	165	Nigeria	-	09/2017–06/2019	Monkeypox cases reported to the Nigeria CDC	Headache 78
Eseigbe et al., 202131	2	Nigeria	-	2018	First reported nigerian monkeypox cases admitted to Bingham University Teaching Hospital in Jos, Plateau State	Headache 2
Hughes et al., 202125	134	DRC	-	09/2009–04/2014	Individuals co-infected with VZV and monkeypox, identified through a surveillance program in Tshuapa Province	Headache 99, myalgia 90, fatigue 115
Pittman et al., 202232	216	DRC	-	03/2007– 08/2011	Patients admitted to General Reference Hospital of Kole the rainforest of the Congo River basin	Headache 49, myalgia 15, dizziness 3, visual deficit 5, confusion 4, fatigue 11	Follow-up assessment at discharge: confusion 1, lethargy/stupor 1
Ježek et al., 198730	209	Zaire/DRC	-	1980–1985	Public health surveillance programme	Encephalitis 1, coma 1	Reported that headache was common but no figure given. Three-year-old unvaccinated girl developed encephalitis and died in a coma on the second day of admission.
Boumandouki et al., 200729	0 (8 unconfirmed)	DRC	-	05/2003–07/2003	Outbreak surveillance study in DRC	Myalgia 2
Kalthan et al.,201633	12	Central African Republic	-	12/2016– 02/2016	Individuals diagnosed with monkeypox in the district of Bangassou	Headache 2
Huhn et al., 20054	34	USA	West African	06/2003	Individuals identified through CDC surveillance with monkeypox during 2003 midwest USA outbreak	Headache 23, myalgia 19, seizure 1, confusion 2, encephalitis 1	Six-year old girl who underwent intubation and mechanical ventilation for encephalitis
Croft et al., 200728	19	USA	West African	05/2003–13/2003	Veterinary workers exposed to infected prairie dogs	Headache 13
Reed et al., 200417	11	USA	West African	05/2003–06/2003	Department of health / CDC outbreak investigation in Wisconsin (all linked to Prairie dog exposure)	Headache 11, myalgia 1	Neurological examinations normal in all patients
Reynolds et al.,200618	37	USA	West African	05/2003–07/2003	Wisconsin outbreak investigation	Headache 32, myalgia 36
Anderson et al, 200327	1	USA	West African	05/2003–07/2003	Midwest USA outbreak case report	Headache 1, myalgia 1, fatigue 1	No focal neurological signs on admission
Sejvar et al., 200426	3	USA	West African	05/2003	Family cluster in Midwest outbreak	Headache 2, seizure 1, altered mental status 1, delirium/encephalopathy 1, encephalitis 1	Six year old girl with encephalitis: unresponsive, pupillary dilatation, muscle rigidity
Adler et al., 20225	7	UK	West African	08/2018 – 09/2021	Patients admitted to high consequence infectious diseases centres in the UK	Headache 1, pain 1, low mood 3, emotional lability 1	Patient with low mood and emotional lability also had alcohol withdrawal
Learned et al.,200534	3	ROC	-	04/2003–05/2003	Outbreak within a community in Impfondo	Headache 1, irritability 2, distress 4, fatigue 2,
Reynolds et al.,201335	2	ROC	Congo Basin	04/2010–11/2010	Surveillance study established in in Likouala region	Headache 1, fatigue 1

^an with confirmed monkeypox.

^btime period of data collection.

Centre for Disease Control (CDC)

Democratic Republic of Congo (DRC)

Republic of Congo (ROC)