Does anyone have any insight into chronic viral meningitis? My husband has been ill x 10 months and no one can give us any solid insight. S/S include varying degrees of HA, LE weakness, short term memory loss, cognition deficits, ets. Any help or direction would be great!
Apr 3, '03
Of course, you've got an infectious disease specialist helping you as well as a neurologist possibly?
Anyways, I hadn't even heard of chronic viral meningitis before, but with a quickie search of the internet, I came across this written by a neurolgist in response to a question from another individual:
What you describe is a chronic meningitis. Yes, you could have Mollaret's or recurrent HSV-1. If this is what is thought to be occurring then acylovir is the treatment of choice. What we have found is that in at least of 1/3 of asceptic meningiditis the agent is not found. There are at least 5 categories of chronic asceptic meningitis, doubtful that you have 3 of them. So the other two are as follows. The two things that you might have is a small vessel vasculitis (resulting from the initial infection) or what we call chronic persistent meningitis of obscure etiology. Usually to distinquish between the two, multiple LPs are necessary and CSF analysis needed. A first step at CCF is usually a MRI with GAD of the spinal cord looking for vasculitis. If found then steriods are the medication of choice. What is thought about the latter, is that it is viral. We search hard for PCR positive HSV, atypical lymphocytes, use T and B cell markers, ANA, etc of the CSF. Frankly, most of the time we come up empty. The Mayo Clinc published a report of 39 (?) of their patients with this disorder and eventually all but 3 recovered. It took months to several years though.
So, I would suggest the MRI and then it depends on what the result comes out like and your desire to find the etiology. Sorry that I couldn't be of more help. The medications suggested sound good, there are others but your physicians will give you what is best.
Remember this doctor was answering someone else's questions, but I thought the interesting part (also the unfortunate part) is that it can take up to several years to recover for some individuals....
Apr 7, '03
Chronic viral meningitis is not a standard recognized medical term. Since length of illness depends on the natural history of infection or course and the amount of permanent damage. You should discuss with your husband 's physician. Depending on the permanent brain damage the signs and symptoms not the infection can last up to a lifetime. Another resource is the Nursing Books section of this web site or search medical-surgical nursing on any book store web site. Taber's or Brunner's or two good resources I refer students to.
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