View source for Mollaret's meningitis

__NOTOC__
{{DiseaseDisorder infobox
 | Name           = Mollaret's meningitis
 | Image          = Illu_meninges.jpg
 | Caption        = Meninges of the central nervous system: dura mater, arachnoid, and pia mater. - By SVG by Mysid, original by SEER Development Team [1] - Vectorized in Inkscape by Mysid, based on work by SEER Development Team, Public Domain, https://commons.wikimedia.org/w/index.php?curid=10485059
 }}
{{Herpes simplex}}
{{CMG}}

{{SK}} Benign recurrent meningitis; Mollaret disease; benign multirecurrent endothelioleucocytal meningitis

==Overview==
Mollaret's meningitis is a recurrent [[inflammation]] of the protective membranes covering the [[brain]] and [[spinal cord]], known collectively as the [[meninges]]. Mollaret's meningitis is caused by [[herpes simplex virus]]. It is a recurrent, benign, [[aseptic meningitis]]. 
==Historical Perspectve==
It is named for Pierre Mollaret.<ref>{{WhoNamedIt|synd|1537}}</ref><ref>P. Mollaret. Méningite endothélio-leucocytaire multirécurrente bénigne. Syndrome nouveau ou maladie nouvelle? (Documents cliniques). Revue neurologique, Paris, 1944, 76: 57-76.</ref>
==Diagnosis==
===History and Symptoms===
Mollaret's meningitis is characterized by recurrent episodes of severe [[headache]], [[meningismus]], and [[fever]].
===Laboratory Findings===
Investigations include [[blood test]]s ([[Electrolyte|electrolytes]], [[liver]] and [[kidney]] function, [[Inflammatory|inflammatory markers]] and a [[complete blood count]]) and usually [[X-ray]] examination of the chest. The most important test in identifying or ruling out meningitis is analysis of the [[cerebrospinal fluid]] (fluid that envelops the brain and the spinal cord) through [[lumbar puncture]] (LP). However, if the patient is at risk for a cerebral mass lesion or elevated [[intracranial pressure]] (recent [[head injury]], a known immune system problem, localizing neurological signs, or evidence on examination of a [[ICP|raised ICP]]), a [[lumbar puncture]] may be contraindicated because of the possibility of fatal [[brain herniation]]. [[Cerebrospinal fluid]] (CSF) [[pleocytosis]] with large "endothelial" cells, [[neutrophils]], and [[lymphocyte]]s; and attacks separated by symptom-free periods of weeks to months; and spontaneous remission of symptoms and signs.<ref>Mollaret's meningitis at patient.co.uk</ref>
===CT/MRI===
In such cases a [[Computed tomography|CT]] or [[Magnetic resonance imaging|MRI]] scan is generally performed prior to the [[lumbar puncture]] to exclude this possibility. Otherwise, the CT or MRI should be performed after the LP, with MRI preferred over CT due to its superiority in demonstrating areas of [[cerebral edema]], [[ischemia]], and meningeal [[inflammation]]. During the [[lumbar puncture]] procedure, the opening pressure is measured. A pressure of over 180 mm H<sub>2</sub>O is indicative of bacterial meningitis. Mollaret's meningitis is suspected based on clinical criteria and confirmed by [[HSV-1|HSV 1]] or [[HSV-2|HSV 2]] on [[PCR]] of [[CSF]].

==Treatment==
===Medical Therapy===
[[Acyclovir]] is the treatment of choice for Mollaret's meningitis.
==Related Chapters==
* [[Encephalitis]]
* [[Herpes simplex virus]]
* [[Meningitis]]
==References==
{{reflist|2}}

{{Viral diseases}}
{{Diseases of the nervous system}}
	
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Sexually transmitted diseases]]
[[Category:Viral diseases]]
[[Category:Gynecology]]
[[Category:Dermatology]]
[[Category:Obstetrics]]
[[Category:Disease]]
[[Category:Emergency mdicine]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Otolaryngology]]
[[Category:Urology]]