Benigh Reccurent Lymphocytic Meningitis (Mollaret Meningitis): a Case Report
O. N. Zhadan,
L. V. Shagal,
M. A. Barabanova,
L. V. Timchenko,
O. V. Stoyanova,
T. A. Petropavlovskaya,
Y. Y. Kasyanenko,
A. N. Torgashova,
V. A. Porkhanov https://doi.org/10.23934/2223-9022-2018-7-3-260-264
Abstract
The article reports a clinical case of a patient with four recurring episodes of headache, nausea and focal neurological symptoms (hemiparesis, sensorimotor aphasia, adversive epileptic seizures) with a rapid onset of remission. The clinical picture of the disease was supplemented with lymphocytic pleocytosis and cell-protein dissociation in the cerebrospinal fluid, which allowed to diagnose benign recurrent lymphocytic meningitis (Mollaret meningitis) and to conduct pathogenetic therapy. The aim of this work is to improve the diagnosis of rare Mollaret meningitis.
About the Authors
O. N. Zhadan
Institute — regional Clinical hospital no. 1 n.a. Prof. S.V. Ochapovsky of the Ministry of health of the Krasnodar Territory; Kuban State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Zhadan Olga Nikolayevna - Physician of the Superior Expert Category, Head of the Department of Neurorehabilitation, RI – RCH no. 1.
167 1 Maya St., Krasnodar 350086
L. V. Shagal
Institute — regional Clinical hospital no. 1 n.a. Prof. S.V. Ochapovsky of the Ministry of health of the Krasnodar Territory; Kuban State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Shagal Leonid Viktorovich - Cand. Med. Sci., Assistant of the Department of Neurological Diseases and Neurosurgery with the Course of Neurological Diseases and Neurosurgery of the Faculty of Continuing Education and Professional Retraining, KSMU, Physician of the Superior Expert Category.
4 Mitrofana Sedina St., Krasnodar 350063
M. A. Barabanova
Institute — regional Clinical hospital no. 1 n.a. Prof. S.V. Ochapovsky of the Ministry of health of the Krasnodar Territory; Kuban State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Barabanova Marianna Anatolyevna - Dr. Med. Sci., Professor of of the Department of Neurological Diseases and Neurosurgery with the Course of Neurological Diseases and Neurosurgery of the Faculty of Continuing Education and Professional Retraining, KSMU, Physician of the Superior Expert Category Head of the Department of Neurorehabilitation, RI – RCH no. 1.
4 Mitrofana Sedina St., Krasnodar 350063
L. V. Timchenko
Institute — regional Clinical hospital no. 1 n.a. Prof. S.V. Ochapovsky of the Ministry of health of the Krasnodar Territory; Kuban State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Timchenko Lyudmila Viktorovna - Physician of the Superior Expert Category, Head of the Department of Neurorehabilitation, RI – RCH no. 1.
167 1 Maya St., Krasnodar 350086
O. V. Stoyanova
Institute — regional Clinical hospital no. 1 n.a. Prof. S.V. Ochapovsky of the Ministry of health of the Krasnodar Territory; Kuban State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Stoyanova Olga Viktorovna - Cand. Med. Sci., Associate Professor of the Department of Neurological Diseases and Neurosurgery with the Course of Neurological Diseases and Neurosurgery of the Faculty of Continuing Education and Professional Retraining, KSMU, Physician of the Superior Expert Category, Krasnodar.
4 Mitrofana Sedina St., Krasnodar 350063
T. A. Petropavlovskaya
Institute — regional Clinical hospital no. 1 n.a. Prof. S.V. Ochapovsky of the Ministry of health of the Krasnodar Territory; Kuban State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Petropavlovskaya Tatyana Aleksandrovna - Cand. Med. Sci., Associate Professor of the Department of Neurological Diseases and Neurosurgery with the Course of Neurological Diseases and Neurosurgery of the Faculty of Continuing Education and Professional Retraining, KSMU, Physician of the Superior Expert Category.
4 Mitrofana Sedina St., Krasnodar 350063
Y. Y. Kasyanenko
Institute — regional Clinical hospital no. 1 n.a. Prof. S.V. Ochapovsky of the Ministry of health of the Krasnodar Territory; Kuban State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Kasyanenko Yana Yevgenyevna - Clinical Resident Neonatologist of the Children’s Diseases Department, V.A. Almazov NMRC.
167 1 Maya St., Krasnodar 350086
A. N. Torgashova
Institute — regional Clinical hospital no. 1 n.a. Prof. S.V. Ochapovsky of the Ministry of health of the Krasnodar Territory; Kuban State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Torgashova Anastasia Nikolayevna - Physician of the Superior Expert Category, Neurologist of the Department of Neurology, RI – RCH no. 1.
167 1 Maya St., Krasnodar 350086
V. A. Porkhanov
Institute — regional Clinical hospital no. 1 n.a. Prof. S.V. Ochapovsky of the Ministry of health of the Krasnodar Territory; Kuban State Medical University of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Porkhanov Vladimir Alekseyevich - Dr. Med. Sci., Professor, Academicial (Full Member) of the Russian Academy of Sciences, Chief Thoracic Surgeon of the Krasnodar Territory, Head of the Department of Oncology with the Course of Thoracic Surgery KSMU.
4 Mitrofana Sedina St., Krasnodar 350063
References
1. Mollaret P. Benign multi-recurrent endothelioleukocytic meningitis. Rev Neurol (Paris). 1977; 133(4): 225–244. PMID: 929028.
2. Kupila L., Vainionpaa R., Vuorinen T., et al. Recurrent lymphocytic meningitis: the role of herpes viruses. Arch Neurol. 2004; 61(10): 1553–1557. PMID: 15477509.
3. Yakhno N.N., Shtul’man D.R., eds. Diseases of the nervous system. 2nd ed., rev. and sup. Moscow: Meditsina Publ., 2001. Vol.1. 326 p. (In Russian).
4. Pearce J.M. Mollaret’s meningitis. Eur Neurol. 2008; 60(6): 316–317. PMID: 18832846. DOI: 10.1159/000159930.
5. Prandota J. Mollaret meningitis may be caused by reactivation of latent cerebral toxoplasmosis. Int J Neurosci. 2009; 119(10): 1655–1692. PMID: 19922380.
6. Tedder D.G., Ashley R., Tyler K.L., Levin M.J. Herpes simplex virus infection as a cause of benign recurrent lymphocytic meningitis. Ann Intern Med. 1994; 121(1): 334–338. PMID: 8042822.
7. Bruyn G.W., Straathof L.J., Raymakers G.M. Mollaret’s meningitis. Differential diagnosis and diagnostic pitfalls. Neurology. 1962; 12: 745–753. PMID: 14016408.
8. Kallio-Laine K, Seppänen M, Kautiainen H., et al. Recurrent lymphocytic meningitis positive for herpes simplex virus type 2. Emerg Infect Dis. 2009; 15(7): 1119–1122. PMID: 19624935. DOI: 10.3201/eid1507.080716.
9. Thomson R.B. Jr, Bertram H. Laboratory diagnosis of central nervous system infection. Infect Dis Clin North Am. 2001; 15(4): 1047–1071. PMID: 11780267.
10. Abu Khattab M., Al Soub H., Al Maslamani M., et al. Herpes simplex virus type 2 (Mollaret’s) meningitis: a case report. J Infect Dis. 2009; 13(6): e476-479. PMID: 19329344. DOI: 10.1016/j.ijid.2009.01.003.
11. Bruyn G., Straathof J., Raymakers G. Mollaret’s meningitis: differential diagnosis and diagnostic pitfalls. Neurology. 1962; 12: 745–753. PMID: 14016408.
12. Venot C., Beby A., Bourgoin A., et al. Genital recurrent infection occurring 6 months after meningitis due to the same herpes simplex virus type 2 (HSV-2) strain evidence by restriction endonuclease analysis. J Infect. 1998; 36(2): 233–235. PMID: 9570665.
13. Mirakhur B., McKenna M. Recurrent herpes simplex type 2 virus (Mollaret) meningitis. J Am Board Fam Pract. 2004; 17(4): 303–305. PMID: 15243021.
14. Tyler K.L. Herpes simplex virus infections of the central nervous system: encephalitis and meningitis, including Mollaret’s. Herpes. 2004; 11(Suppl 2): 57A–64. PMID: 15319091.
15. Procop G.W., Yen-Lieberman B., Prayson R.A., Gordon S.M. Mollaretlike cells in patients with West Nile virus infection. Emerg Infect Dis. 2004; 10(4): 753–754. PMID: 15211999. DOI: 10.3201/eid1004.030783.
16. Hermans P.E., Goldstein N.P., Wellman W.E. Mollaret’s meningitis and differential diagnosis of recurrent meningitis. Am J Med. 1972; 52(1): 128–140. PMID: 4111896.
17. Shalabi M., Whitley R.J. Recurrent Benign Lymphocytic Meningitis. Clin Infect Dis. 2006; 43(9): 1194–1197. PMID: 17029141.
18. Jackson A. Acute viral infections. Curr Opin Neurol. 1995; 8(3): 170–174. PMID: 7551114.
Review
For citations:
Zhadan O.N., Shagal L.V., Barabanova M.A., Timchenko L.V., Stoyanova O.V., Petropavlovskaya T.A., Kasyanenko Y.Y., Torgashova A.N., Porkhanov V.A. Benigh Reccurent Lymphocytic Meningitis (Mollaret Meningitis): a Case Report. Russian Sklifosovsky Journal "Emergency Medical Care". 2018;7(3):260-264. https://doi.org/10.23934/2223-9022-2018-7-3-260-264
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