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Mollaret's meningitis associated with herpes simplex type 2 infection

Department of Clinical Neurological Sciences (Drs. Picard, Silva, and Rice), University of Western Ontario, and the John P. Robarts Research Institute (Dr. Dekaban), London, ON, Canada.

We describe three patients with benign recurrent aseptic meningitis (Mollaret's meningitis). For one of these cases, the episodes of meningitis were associated with herpetic outbreaks. Mollaret cells, which are a hallmark of Mollaret's meningitis, were present in the CSF from two of the three patients. In all cases, herpes simplex virus type 2 DNA was present in the CSF during the acute illness as detected by polymerase chain reaction amplification, although viral cultures from CSF were all negative. Herpesviruses, notorious for frequent and sporadic recurrence, are ideal candidates for the cause of Mollaret's meningitis.

Address correspondence and reprint requests to Dr. George P.A. Rice, Department of Clinical Neurological Sciences, University Hospital, Room 7-L10, 339 Windermere Road, London, ON, Canada N6A 5A5.

Supported by a grant (R90-40) from the Physicians Services Incorporated Foundation. G.P.A.R. and G.A.D. are recipients of Career Development Awards from the Ministry of Health of Ontario. F.J.P. is a postdoctoral fellow funded by the Raymond C. Raymond Foundation.

Presented in part at the 44th annual meeting of the American Academy of Neurology, San Diego, CA, May 1992.

Received November 24, 1992. Accepted for publication in final form February 2, 1993.

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