[Restatment. Mollaret's meningitis].

Area of Science:

• Neurology
• Infectious Diseases

Background:

• Mollaret's Meningitis (MM) is a rare condition characterized by recurrent episodes of aseptic lymphocytic meningitis.
• It is most commonly associated with Herpes Simplex Virus type 2 (HSV-2) infection.
• A significant percentage of patients with a first HSV-2 meningitis may experience recurrent episodes.

Purpose of the Study:

• To describe the clinical characteristics, diagnosis, pathophysiology, and management of Mollaret's Meningitis.
• To emphasize the importance of recognizing MM to prevent diagnostic delays and unnecessary invasive procedures.

Main Methods:

• Clinical diagnosis based on recurrent meningitis symptoms and cerebrospinal fluid (CSF) analysis showing lymphocytic pleocytosis.
• Identification of HSV-2 via PCR in CSF for definitive diagnosis.
• Exclusion of other causes of recurrent meningitis when PCR is negative.

Main Results:

• Recurrent meningitis attacks present with sudden onset and complete recovery between episodes.
• HSV-2 PCR is a key diagnostic tool, though negative PCRs require exclusion of other etiologies.
• Antiviral treatment is effective for the first episode, but no current treatments consistently reduce recurrence frequency or duration.

Conclusions:

• Mollaret's Meningitis is typically linked to latent HSV-2 reactivation from sacral ganglia.
• The prognosis for MM is generally excellent, with a natural tendency for recurrence frequency to decrease over time.
• Awareness of MM is crucial for accurate diagnosis, avoiding extensive investigations, and managing patient care effectively.