Mollaret's meningitis: Difference between revisions
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{{DiseaseDisorder infobox | {{DiseaseDisorder infobox | ||
| Name = Mollaret's meningitis | | Name = Mollaret's meningitis | ||
| Image = Illu_meninges.jpg | | Image = Illu_meninges.jpg | ||
| Caption = Meninges of the central nervous system: dura mater, arachnoid, and pia mater. | | Caption = Meninges of the central nervous system: dura mater, arachnoid, and pia mater. | ||
}} | }} | ||
{{Herpes simplex}} | {{Herpes simplex}} | ||
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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> | 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> | ||
==Signs and | ==Signs and Symptoms== | ||
Mollaret's meningitis is charecterized by recurrent episodes of severe headache, meningismus, and fever; cerebrospinal fluid (CSF) pleocytosis with large "endothelial" cells, neutrophils, and lymphocytes; 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> | Mollaret's meningitis is charecterized by recurrent episodes of severe headache, meningismus, and fever; cerebrospinal fluid (CSF) pleocytosis with large "endothelial" cells, neutrophils, and lymphocytes; 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> | ||
==Diagnosis== | ==Diagnosis== | ||
Investigations include [[blood test]]s (electrolytes, liver and kidney function, 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 raised ICP), a lumbar puncture may be contraindicated because of the possibility of fatal [[brain herniation]]. 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. | Investigations include [[blood test]]s (electrolytes, liver and kidney function, 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 raised ICP), a lumbar puncture may be contraindicated because of the possibility of fatal [[brain herniation]]. 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. | ||
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==Treatment== | ==Treatment== | ||
[[Acyclovir]] is the treatment of choice for Mollaret's meningitis. | [[Acyclovir]] is the treatment of choice for Mollaret's meningitis. | ||
== | ==Related Chapters== | ||
* [[Encephalitis]] | * [[Encephalitis]] | ||
* [[Meningitis]] | * [[Meningitis]] | ||
Revision as of 15:26, 5 December 2012
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Herpes simplex Microchapters |
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Mollaret's meningitis On the Web |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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.
It is named for Pierre Mollaret.[1][2]
Signs and Symptoms
Mollaret's meningitis is charecterized by recurrent episodes of severe headache, meningismus, and fever; cerebrospinal fluid (CSF) pleocytosis with large "endothelial" cells, neutrophils, and lymphocytes; and attacks separated by symptom-free periods of weeks to months; and spontaneous remission of symptoms and signs. [3]
Diagnosis
Investigations include blood tests (electrolytes, liver and kidney function, 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 raised ICP), a lumbar puncture may be contraindicated because of the possibility of fatal brain herniation. In such cases a CT or 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 H2O is indicative of bacterial meningitis.
Mollaret's meningitis is suspected based on clinical criteria and confirmed by HSV 1 or HSV 2 on PCR of CSF.
Treatment
Acyclovir is the treatment of choice for Mollaret's meningitis.
Related Chapters
References
- ↑ Template:WhoNamedIt
- ↑ P. Mollaret. Méningite endothélio-leucocytaire multirécurrente bénigne. Syndrome nouveau ou maladie nouvelle? (Documents cliniques). Revue neurologique, Paris, 1944, 76: 57-76.
- ↑ Mollaret's meningitis at patient.co.uk
Template:Viral diseases Template:Diseases of the nervous system