monkaE represents extreme anxiety, panic, or intense nervousness taken to the highest level. It's used when something is going very wrong, when a situation is becoming increasingly stressful, or when tension is building to an almost unbearable degree. The emote conveys a sense of impending doom or overwhelming stress. It's essentially monkaS amplified - where monkaS might be used for moderate concern, monkaE is reserved for maximum panic mode.
monkaE is a variation of the monkaS emote, which itself derives from Pepe the Frog. The original monkaS was created by a user named MonkaSenpai in 2016 and uploaded to FrankerFaceZ. The monkaE variant features Pepe with an extremely exaggerated anxious expression, with the character appearing to zoom in or move forward rapidly, creating a more intense version of the nervous/anxious Pepe. The 'E' suffix typically indicates an 'extreme' or exaggerated version of the base emote. This variant became popular on BetterTTV and FrankerFaceZ around 2017-2018 as streamers and viewers wanted even more expressive versions of the anxiety emote.
monkaE is commonly spammed when: a streamer is in an extremely dangerous situation in a game and likely to die; when technical difficulties are getting worse; during highly tense competitive moments with everything on the line; when a streamer is about to make a potentially catastrophic decision; during horror game jump scares or very scary moments; when chat anticipates something going terribly wrong; or when drama is escalating rapidly. It's often used in rapid succession or combined with other monka variants to express escalating levels of anxiety.