[A case of indomethacin-inhibited recurrent periodical attacks of Mollaret's meningitis].

A 65-year-old woman was admitted to our hospital on May 28, 1990, because of recurrent high fever, over 39 degrees C, headache and general fatigue. In June 1988, she suffered the first episode of high fever, headache and general fatigue. Since then, those symptoms attacked her recurrently at intervals of 7 to 10 days. She was admitted to a hospital for two months in 1988. However, the etiology was unclear and treatment, including antibiotics, was not effective. After admission to our hospital, the symptoms of high fever, headache and general fatigue developed suddenly, lasted for 2 to 4 days, then disappeared spontaneously. These symptoms recurred periodically at intervals of 7 to 10 days. Findings of lumbar puncture during the period with severe symptoms revealed a leukocytic pleocytosis (polymorphonuclear neutrophil count: 1,324/3 mm3, mononuclear cell count: 48/3 mm3, without Mollaret cells) increased protein (0.81 g/l) and decreased glucose (0.28 g/l). Cerebrospinal fluid (CSF) examination during the period without symptoms showed a dramatic decrease of pleocytosis (polymorphonuclear neutrophil count: 5/3 mm3, mononuclear cell count: 17/3 mm3, without Mollaret cells) with improved protein (0/64 g/l) and glucose (0.40 g/l). Various examinations revealed no evidence of infection, malignancy, collagen disease, endocrine disease or any disorders in the nervous system. Moreover, bacterial cultures of blood and CSF were negative and a brain CT scan showed no abnormal findings. We diagnosed this case as Mollaret's meningitis and gave 25 mg indomethacin after every meal (75 mg/day). Her symptoms were improved abruptly and the duration of symptoms shortened and symptom-free intervals became longer.(ABSTRACT TRUNCATED AT 250 WORDS)