Mollaret meningitis is a type of meningitis due to a viral infection (aseptic meningitis) that occurs multiple times.[15220] It is characterized by repeated episodes of meningitis, typically lasting two to five days, occurring weeks to years apart.[15220][15221] Common signs and symptoms during an episode may include severe headache, fever, nausea, vomiting, sensitivity to light (photophobia), and stiff neck.[15220][15222] Some people also experience temporary neurological symptoms such as double vision, hallucinations, altered consciousness, cranial nerve palsy, or seizures.[15220][15221][15222] Almost half of people with Mollaret meningitis develop long-term neurological impairment such as problems with memory, balance, coordination, and/or hearing.[15220]
The virus most commonly responsible for Mollaret meningitis is the herpes simplex virus (usually HSV-2, the type generally responsible for genital herpes, but also HSV-1).[15220][15221] However, more than half of people with Mollaret meningitis due HSV-2 do not report a history of genital herpes.[15223] Epstein-Barr virus has also been associated with Mollaret meningitis. The diagnosis typically involves detecting herpes simplex virus DNA in the cerebrospinal fluid, which is collected during a lumbar puncture (spinal tap).[15220][15221] This test can diagnosis other types of meningitis as well. Treatment may involve an antiviral drug such as acyclovir to treat and prevent recurrent episodes of viral meningitis, as well as various medications to treat specific symptoms present in each person.[15220][15221] While antiviral drugs have reportedly improved symptoms in many cases, the effectiveness of antiviral therapy is difficult to measure due to the rarity of the disease and its recurrent and spontaneous nature.[15220] While aseptic meningitis usually is not fatal, serious complications such as encephalitis and coma can develop in severe cases.[15222]
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