Benign recurrent lymphocytic meningitis is a form of aseptic meningitis. The precise cause is not known but herpes simplex virus 2 has been implicated.


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.



(1) persistence of neurologic findings

(2) positive cultures for bacteria, fungus, or virus

(3) evidence of a parasitic infection


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