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Oluwatobiloba Jaiyeola
A new study conducted by the Centers for Disease Control and Prevention has suggested that the monkeypox virus can lead to neurologic complications such as brain inflammation.
Public Health officials discovered encephalomyelitis cases associated with monkeypox in two previously healthy young men.
Encephalomyelitis is the inflammation of both the brain and the spinal cord. It can be caused by a variety of conditions, including viruses that infect the nervous system.
In both cases, the CDC report revealed that brain inflammation symptoms developed between five to nine days after the onset of monkeypox.
The first patient, a supposedly immunocompetent gay man in his 30s in Colorado, first developed fever, chills, and unease. Three days after symptom onset, he developed a rash which yielded a positive result for the monkeypox virus after being tested.
Nine days later, the man developed progressive upper and lower extremity weakness and numbness on the left side of his body. He was also said to have had difficulty urinating and recurrent prolonged erections.
During hospitalisation, MRI scans of the brain presented evidence of encephalomyelitis.
The CDC said treatment with oral tecovirimat, the monkeypox antiviral treatment known as TPOXX, including steroids for inflammation and immunoglobulin infusions for his immune system, began immediately after the onset of neurologic symptoms.
Given concerns for possible continued spinal cord inflammation, the patient got a plasma exchange, which improved symptoms.
After hospitalization, the CDC said he was discharged to outpatient rehabilitation therapy and used an assistive walking device for a month. He was also referred to outpatient neurosurgery for his presumed chronic cervical spinal canal inflammation.
For the second patient, a supposedly immunocompetent gay man in his 30s in Washington DC also developed fever and muscle pain which was followed by a rash and tested positive for monkeypox.
Five days after symptom onset, he had trouble controlling his bowel movements and bladder, and also progressive weakness in both legs. During hospitalisation, his condition progressed in the next two days and he started experiencing an altered mental state and decreased level of alertness.
He was transferred to the intensive care unit where MRI brain scans showed evidence of encephalomyelitis. The man also received tecovirimat, steroids, immunoglobulin infusions, and plasma exchange. He improved a lot due to the plasma exchange.
After five sessions, the patient began to substantially improve and was speaking again and following commands, he also had improvement in his lower extremity weakness.
He was discharged to acute inpatient rehabilitation and used an assistive walking device. He was given rituximab, a monoclonal antibody medication, for immunosuppressive therapy.
“Clinicians and public health professionals should be aware of the range of possible clinical presentations of monkeypox virus infections and potential treatments.
“Suspected cases should be reported to state, tribal, local or territorial health departments to improve understanding of the range of clinical manifestations of monkeypox virus infections and treatment options.
“Persons who have been exposed to monkeypox or are at higher risk of being exposed may be vaccinated against monkeypox to reduce the chance of disease and can consider other protective measures to reduce their risk for exposure to monkeypox virus,” the CDC stated.
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