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[复发性无菌性脑膜炎(莫拉雷脑膜炎)——自发性及药物性病因]

[Recurrent aseptic meningitis (Mollaret meningitis)--spontaneous and drug-induced origin].

作者信息

Thilmann A F, Möbius E, Thilmann R R, Töpper R

机构信息

Neurologische Klinik mit Klinischer Neurophysiologie, Alfried Krupp von Bohlen und Halbach Krankenhauses, Essen.

出版信息

Fortschr Neurol Psychiatr. 1991 Dec;59(12):493-7. doi: 10.1055/s-2007-1000725.

Abstract

Since its initial description by Mollaret in 1944, the etiology of the chronic aseptic meningitis has remained unknown. This rare disease may cause diagnostic problems if bacterial or viral causes are suspected. A different form of aseptic meningitis may be seen following a variety of drug treatments, especially with non-steroidal anti-rheumatic drugs: In many reports since 1978, meningitic attacks following administration of ibuprofen have been reported. We describe two cases of Mollaret-Meningitis with certain specialities: one case shows clear encephalitic involvement with aphasia in all six attacks. In the other case, five meningitic attacks appeared spontaneously, while two were drug-induced: the first attack was seen after a lumbar myelography with lopamidol and one attack appeared two hours after oral administration of 400 mg ibuprofen. It is suggested that Mollaret-Meningitis is a special form of a drug-induced allergic reaction, the provoking agent of which remains unknown.

摘要

自1944年莫拉雷首次描述以来,慢性无菌性脑膜炎的病因一直不明。如果怀疑是细菌或病毒原因,这种罕见疾病可能会引发诊断问题。在接受各种药物治疗后,尤其是使用非甾体类抗风湿药物时,可能会出现另一种形式的无菌性脑膜炎:自1978年以来的许多报告中,都有服用布洛芬后发生脑膜炎发作的报道。我们描述了两例具有某些特殊情况的莫拉雷脑膜炎病例:一例在所有六次发作中均表现出明显的脑实质受累并伴有失语。另一例中,五次脑膜炎发作是自发出现的,而两次是药物诱发的:第一次发作是在使用碘帕醇进行腰椎脊髓造影后出现的,另一次发作是在口服400毫克布洛芬两小时后出现的。有人认为,莫拉雷脑膜炎是药物诱发过敏反应的一种特殊形式,其诱发因素尚不清楚。

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