Synonym: Mollaret meningitis
Recurrent episodes: typically 3-10 episodes each lasting 1-3 days (up to 14 days) with spontaneous resolution
Some recommend that the term not be used if the patient has only had 1 or 2 episodes.
Typical patient: adult female
Clinical features:
(1) acute onset of severe headache
(2) fever
(3) photophobia
(4) meningismus
(5) Half of patients have transient neurologic findings (seizures, hallucinations, cranial nerve palsy, diplopia, depressed level of consciousness).
CSF analysis shows:
(1) pleocytosis with lymphocytosis
(2) slightly elevated protein
(3) normal glucose
Many patients have positive PCR for Herpes simplex 2 viral DNA.
Exclusion:
(1) persistence of neurologic findings
(2) positive cultures for bacteria, fungus, or virus
(3) evidence of a parasitic infection
