Neurological Manifestations of COVID-19 and Monkeypox in Pediatric patients & their management- A state of art systematic review

BACKGROUND: There is an increasing number of cases being reported of neurological manifestations of COVID-19 infection and Monkeypox, both during the course of the infection or as a presenting symptom. We aim to review the neurological manifestations of COVID-19 and Monkeypox in Pediatric patients and their management. METHODS: We conducted a systematic review which included cohort studies and case series or reports involving a pediatric population of patients with a confirmed COVID-19 or Monkeypox infection and their neurological manifestations. We searched the following electronic databases: PubMed, EMBASE, Scopus. RESULTS: From 1136 articles identified, 127 studies were included. Headache, stroke, GBS, seizure, nerve palsies and MISC-C were the most common neurological symptoms caused by COVID-19 while encephalitis was commonly seen in Monkeypox patients. Rare neurological manifestations of COVID-19 included cerebral venous sinus thrombosis, plexopathies, demyelinating disorders, encephalitis etc and rare neurological manifestations of Monkeypox included headache. CONCLUSION: Our review highlights the importance of investigating possible neurological manifestations and closely monitoring these patients to develop a better understanding of the treatment strategies that can be adopted.