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Related Experiment Video

Updated: Oct 13, 2025

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[Restatment. Mollaret's meningitis].

Anne Perisse1, David Delarbre2, Anthony Faivre3

  • 1Antenne médicale de Hyères-Vassoigne, 9e centre médical des armées, Toulon, Franca.

La Revue Du Praticien
|November 18, 2021
PubMed
Summary

Mollaret's Meningitis (MM) is a rare condition often caused by HSV-2, characterized by recurrent meningitis with full recovery between episodes. Diagnosis relies on CSF analysis and HSV-2 PCR, with antivirals used for initial treatment.

Keywords:
MeningitisRare Diseases

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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.