Mollarets meningitis and herpes simplex virus type 1 nejm. Mollarets meningitis fulltext european neurology 2008, vol. Mollaret syndrome definition of mollaret syndrome by. Mollaret was the first to describe a rare form of meningitis that presented as recurrent and brief selflimiting attacks of fever, headache, vomiting, and meningeal irritation with no obvious etiology. Mollaret cells large endothelial cells are considered by many to be the hallmark of mollaret meningitis, although their presence. Possible causes include generalized herpes simplex.
Lol the disease is felt to be benign as much for the patient as it is to their contacts. Synonyms for mollaret meningitis in free thesaurus. With this type of meningitis, there is usually rapid onset of symptoms and resolution without residual damage to the nervous system. A spinal puncture was carried out on march 12 while the patient was still in a symptomfree interval. Mollaret s meningitis is characterized by recurrent episodes of severe headache, meningismus, and fever. The syndrome was first described by the french physician mollaret in 1944. Get a printable copy pdf file of the complete article 869k, or click on a page image. Its resemblance to chemical meningitis caused by repeated spontaneous ruptures of dermoidepidermoid cysts in the. Two years after initiation of acyclovir, the patient remains symptomfree and has had no fur ther hospitalizations for recurrence of meningitis. Mollarets meningitis benign recurrent aseptic meningitis.
Mollaret meningitis synonyms, mollaret meningitis antonyms. Pdf mollarets meningitis is a rare disease characterized by. In recent years there has been increasing evidence to implicate the herpes simplex virus 2 hsv2 in many cases. Mollarets recurrent aseptic meningitis and cerebral epi dermoid cyst. Herpes simplex virus type 2associated recurrent aseptic mollarets meningitis in genitourinary medicine clinic. Mollaret meningitis was first described by mollaret in 1944 as a form of aseptic meningitis.
Chronic and recurrent meningitis practical neurology. Mollaret s meningitis is felt to be rareso if you ve got a client with confirmed mollaret s. Mollaret s recurrent aseptic meningitis and cerebral epi dermoid cyst. Presented here is a new case of benign recurrent aseptic meningitis, or mollarets meningitis, in which cerebrospinal fluid was positive for herpes simplex virus type 2 using the polymerase chain reaction test. Mollaret s meningitis and differential diagnosis of recurrent meningitis.
We found the prevalence of recurrent lymphocytic meningitis associated with herpes simplex virus type 2 hsv2 was 2. The disease is characterised by recurrent at least three episodes, benign no longterm sequelae and brief 25 day episodes of aseptic lymphocytic meningitis, alternating with symptom free interval, mostly caused by hsv2 infection. Recurrent herpes simplex type 2 virus mollaret meningitis jabfm. Mollaret s meningitis is a chronic recurrent form of herpes meningitis. In many ways it resembles recurrent hereditary polyserositis familial mediterranean fever in its natural history, pattern of attacks, and response to colchicine. Canadian journal of neurological sciences journal canadien des sciences neurologiques, vol. This may not be the complete list of references from this article. Jan 25, 2019 mollaret meningitis is a type of meningitis due to a viral infection aseptic meningitis that occurs multiple times. Diagnosis, initial management, and prevention of meningitis.
Sep 02, 2016 mollaret meningitis is thought to be rare. Difficult and recurrent meningitis journal of neurology. Mollarets meningitis and herpes simplex virus type 2 infections show all authors. Cerebrospinal fluid csf examination remains the sole diagnostic modality. Recurrent lymphocytic meningitis rlm is a rare disease, characterized by attacks of sudden onset aseptic meningitis followed by complete recovery and unpredictable recurrences. Mollarets meningitis, first described by mollaret in 1944 1, is a rare disease characterized by recurrent episodes of. Mollaret meningitis is characterized by three or more episodes of benign recurrent aseptic. Mollaret meningitis article about mollaret meningitis by. Mollaret meningitis is a type of meningitis due to a viral infection aseptic meningitis that occurs multiple times.
The disease is characterised by recurrent at least three episodes, benign no longterm sequelae and brief 25 day episodes of aseptic lymphocytic meningitis, alternating with symptom free. Herpes simplex virus type 2associated recurrent aseptic. Veyssier the authors report a case of aseptic meningitis due to spontaneous rupture of an intracranial epidermoid cyst. It has been suggested that if the strict criteria above are followed, these cases should be excluded, and the term mollaret s meningitis reserved for true idiopathic cases. Mollaret s meningitis also referred to as recurrent benign lymphocytic meningitis, is characterized by a transient and recurrent onset of neurological symptoms such as headaches, fever, meningismus and various neurological deficits that last for a few days in a selflimiting fashion. The available literature indicates that the causative agent is herpes simplex virus type 2 hsv2 in the majority of cases and much less frequently herpes simplex virus type 1 hsv1. Mollarets meningitis and herpes simplex virus type 2. Herpes simplex type 2 virus is the causative agent in virtually all cases. Chronic meningitis is defined as the persistence of clinical symptoms and signs of meningitis, with or without abnormal cerebrospinal fluid, for more than four weeks. Mollarets meningitis is characterized by recurrent episodes of severe headache, meningismus, and fever.
Presented here is a new case of benign recurrent aseptic meningitis, or mollaret s meningitis, in which cerebrospinal fluid was positive for herpes simplex virus type 2 using the polymerase chain. Here we present an atypical case of mollarets meningitis in which the patient presented with headache and meningismus in the absence of fever. The attacks are separated by symptomfree periods that last weeks to months, and the. Today, herpes simplex virus hsv is considered the cause of most cases of mollarets meningitis. Cases of idiopathic recurrent benign aseptic meningitis were first described by. Introduction the pathogenesis of mollarets meningitis is unknown. Mollarets meningitis is a chronic recurrent form of herpes meningitis. Recurrent benign lymphocytic meningitis clinical infectious.
Mollarets meningitis is a rare form of idiopathic recurrent aseptic meningitis that has a sudden onset. The trip database provides clinical publications about. It is characterized by repeated episodes of meningitis, typically lasting two to five days, occurring weeks to years apart. This syndrome is associated with transient neurological symptoms in onehalf of afflicted patients. A 72yearold woman, previously in good health, suffered for 2 years from attacks of a complex neuropsychiatric syndrome lasting from 2 days to 4 weeks. Mollaret meningitis the turkish journal of pediatrics. Because of its rarity, it is difficult to estimate the exact number of individuals affected by this condition. Check the full list of possible causes and conditions now.
We report a case of mollaret meningitis in a sevenyearold girl who presented with four aseptic meningitis episodes in one year. Eighteen csf samples from 14 patients were studied along with the clinical data. Mollarets meningitis is caused by herpes simplex virus. This video gives you basic information about mollarets meningitis. Mollaret meningitis with a high level of cytokines in the. Mollaret s meningitis is a rare form of benign, recurrent aseptic meningitis characterized by the appearance of a particular mononuclear cell in the csf during the first few days of the illness. When initially described, this form of aseptic meningitis had no identifiable infecting agent.
Looking for online definition of mollaret meningitis in the medical dictionary. Mollarets meningitis mm is a rare disease of benign nature characterized by recurrent episodes of aseptic meningitis. Rosenberg, in cerebrospinal fluid in clinical practice, 2009. Mollaret s meningitis mm is a rare disease of benign nature characterized by recurrent episodes of aseptic meningitis. A rare form of aseptic meningitis characterized by a recurrent pattern with symptom free intervals between episodes. Pdf mollarets meningitis is a rare disease characterized by recurrent and selflimited episodes of lymphocytic meningitis. Mollaret meningitis, recurrent aseptic meningitis, fever. Find mollarets meningitis information, treatments for mollarets meningitis and mollarets meningitis symptoms. Symptoms of mollaret meningitis, which last from 1 to 7 days, include headache, neck ache, fever, and neck stiffness. Presented here is a new case of benign recurrent aseptic meningitis, or mollarets meningitis, in which cerebrospinal fluid was positive for herpes simplex virus type 2 using the polymerase chain. The peripheral white blood cell count alone is not help. Mollarets meningitis is a rare condition with a characteristic clinical and cerebrospinal fluid picture. Mollarets meningitis an overview sciencedirect topics.
Cases of idiopathic recurrent benign aseptic meningitis were first described by mollaret. Important infective causes include partially treated bacterial pyogenic. Pcr was most sensitive in detecting hsv2 dna from cerebrospinal fluid if the sample was taken 25 days after symptom onset. Mollaret s meningitis is caused by herpes simplex virus. Mollaret meningitis definition of mollaret meningitis by. Mollaret meningitis genetic and rare diseases information. Mollaret s meningitis is an unusual and underappreciated syndrome of benign, recurrent aseptic meningitis. Mollarets meningitis also referred to as recurrent benign lymphocytic meningitis, is characterized by a transient and recurrent onset of neurological symptoms such as headaches, fever, meningismus and various neurological deficits that last for a few days in a selflimiting fashion. Looking for online definition of mollaret syndrome in the medical dictionary. The 35yearold praised simon read and matthew laws from the east of england ambulance service nhs trust eeast for their care after her condition rapidly deteriorated. The interval between the attacks in mollaret meningitis is usually symptom free frederiks and bruyn, 1989. Mollarets meningitis and differential diagnosis of recurrent. Recurrent lymphocytic meningitis positive for herpes simplex.
The disease is most often caused by herpes simplex virus type 2 hsv2 and less frequently by other viruses, autoimmune disorders, or medication. Recurrent benign endothelioleukocytic aseptic meningitis was first described by mollaret in 1944 1. Dec 26, 2016 this video gives you basic information about mollaret s meningitis. These episodes, which were followed by intervals of nearly complete recovery, were usually marked by fever, headache, mental confusion, vomiting, ataxia, anisocoria, epileptic seizures and stiffness of the neck. Recurrent lymphocytic meningitis positive for herpes. Mollarets meningitis and herpes simplex virus type 2 infections. Benign recurrent aseptic meningitis mollarets meningitis. Mollaret meningitis today is considered to be a recurrent form of aseptic meningitis, due to the close similarities between the descriptions of walgren and mollaret. Common signs and symptoms during an episode may include severe headache, fever, nausea, vomiting, sensitivity to light photophobia, and stiff neck.
Mollaret s meningitis is a recurrent or chronic inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. However, recent research and studies have suggested that it may be more common than initially thought. Meningitis is inflammation of the thin tissue that surrounds the brain and spinal cord, called the meninges. A search of the existing medical literature revealed 58 previously reported cases of mollarets meningitis in which samples of cerebrospinal fluid were tested for herpes simplex. Table 1 causes of an aseptic meningitis cerebrospinal fluid picture in this article, the major causes of meningitis are considered in turn, highlighting the difficulties which may arise under these three headings. Introduction the pathogenesis of mollaret s meningitis is unknown. Since mollaret s meningitis is a recurrent, benign noncancerous, aseptic meningitis, it is also referred to as benign recurrent lymphocytic meningitis. Recurrent aseptic meningitis secondary to intracranial epidermoid cyst and mollarets meningitis. Mollarets recurrent aseptic meningitis and cerebral. Get a printable copy pdf file of the complete article 869k. Amanda has been living with mollarets meningitis a rare recurring viral form of the disease for more than six years. Is mollarets meningitis caused by herpes simplex virus type 2. Mollarets meningitis caused by herpes simplex virus type.
Broadly speaking, there are three main potential areas of concern. Benign recurrent aseptic meningitis is a rare disorder described by mollaret in 1944. You get it when a virus enters the body through the nose or mouth and travels. Ideal sources for wikipedias health content are defined in the guideline wikipedia. In as many as one third of cases, no cause is found. Mollarets meningitisrecurrent aseptic meningitishsv2 virus. In the remainder, infective, neoplastic and socalled aseptic disorders may be identified. Mollarets meningitis and differential diagnosis of recurrent meningitis. There are a number of risk factors for fungal meningitis, including the use of immunosuppressants such as after organ transplantation, hivaids, and the loss of immunity associated with aging.
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