Reprinted with permission of Life Extension®.
- Current Therapy
- Alternative Therapy
- Overlooked Drugs
Meningitis means inflammation of the brain lining. Viral meningitis is the infection of the central nervous system by enteroviruses that can cause the infection. It is characterized by a severe headache, stiffness of the neck or back, fever, nausea, and malaise. The disease is typically severe and requires emergency medical care. Viral meningitis may occasionally progress to serious neurological confusion, particularly among infants infected before the age of 1 year.
According to the Meningitis Consensus Panel (Washington, D.C.) in May 1999: "The issue with viral meningitis is that there are no available treatments. As a consequence, patients suffer needlessly." Management of viral meningitis in the United States results in $1 billion in direct medical costs and an additional $200 million in indirect costs due to lost productivity. "Having meningitis once is a very scary thing, but to keep getting it, and not even have a clue as to why, is a living nightmare!" These comments from a patient with recurrent viral meningitis were reported by the Meningitis Foundation in 1999.
Mollaret's meningitis (recurrent) is characterized by repeated episodes of fever (up to 104°F), meningismus, and severe headache, which are separated by symptom-free intervals. Individual attacks are sudden, with signs and symptoms reaching maximum intensity within a few hours. Headache, neck pain, generalized muscle aches, and neck stiffness usually persist from 3-6 days, but may be present for up to 3 or more weeks. Following a number of recurrences, which can span a period of years, the disease suddenly disappears. The long-term health of the patient seems not to be adversely affected. However, transient neurologic abnormalities (seizures, diplopia, pathologic reflexes, cranial nerve paresis, hallucinations, and coma) occur in as many as 50% of cases.Current Therapy
* Possible Causes
* Points to Remember
Mollaret's meningitis is a syndrome rather than a disease. As such, the syndrome of Mollaret's meningitis appears to have multiple etiologies. Presently, herpes simplex Type II and to a lesser extent Type I appear to be etiologic in most cases. Because of the rarity of this syndrome, there are no large clinical trials comparing one therapy against another. However, acyclovir (intravenous or oral) or valacyclovir (oral only) are worthy of consideration for both therapy and prophylaxis. A painkiller is generally administered during the first several days of an attack to reduce patient suffering from the severe headaches, stiffness, and overall body aches produced by the onset of the disease. There is currently no antiviral pharmaceutical for viral meningitis, although several are undergoing clinical trails and show promise for use in treatment.
ViroPharma Inc. is conducting a multicenter, double-blind, placebo-controlled, Phase IIIb clinical trial of oral formulation of pleconaril for treatment in adults. In preclinical studies, ViroPharma scientists have shown that pleconaril effectively inhibits the laboratory replication of 96% of the rhinoviruses and enteroviruses isolated from 332 human patients. The patient population from which these clinical samples were obtained exhibited the complete range of diseases caused by these viruses, including a number of fatal infections. Orally administered pleconaril also protected mice from lethal infection by enteroviruses in three distinct animal model systems and was effective even when therapy was initiated after infection in these models (Pevear et al. 1999).Possible Causes
Although there is no simple answer to what causes recurrence, there are some theories. Stress and depression, reduced immune function, and even prolonged sun exposure have been implicated in causing a recurrent meningitis attack. Additionally, the Meningitis Foundation (1999) has cited chromosome defect/FMF, intracranial epidermoid cysts, herpes virus reactivation (systemic), allergic reaction, and chemical reaction as other possible causes of attack.Points to Remember
* Mollaret's meningitis is usually a benign (but painful), self-limited, recurrent, and often febrile meningitis.
* Transient neurologic deficits (seizures, cranial nerve paresis, pathologic reflexes) occur in 50% of cases.
* Mollaret's meningitis may be caused by herpes simplex Type II; acyclovir may play a role in prophylaxis and therapy.
* Anecdotal patient information, as well as scientific evidence, suggests viral meningitis may be triggered by reduced immune system function, allergic response, stress and depression, as well as exposure to the sun.
* Persons who have recurrent meningitis should avoid becoming fatigued or stressed and should avoid excessive exposure to the sun.Alternative Therapy
Nutritional and hormonal therapies to boost immune function, such as the recommended daily dose of Life Extension Mix, melatonin (300 mcg-6 mg taken at bedtime), DHEA (25-50 mg a day), vitamin C (6000 mg a day), and coenzyme Q10 (200 mg a day), are recommended.
For associated pain, consider using Inflacin. Inflacin is a topical pain relief, anti-inflammatory agent. In a double-blind, patient-randomized, placebo-controlled crossover clinical trial enrolling 30 participants, Inflacin was tested to evaluate its analgesic benefit when applying the topical cream to areas of the body affected by stiffness, soreness, and pain. These included hands, feet, knees, and shoulders and muscles of the neck, arms, legs, and back. Results of the study showed that Inflacin significantly reduced pain and stiffness after only one application. On the average, Inflacin reduced pain by 45% after 1 dose in the first 60 minutes of application (Keller 2002). DL-phenylalanine and tyrosine may also be helpful to reduce chronic pain (refer to precautions before use) (see the Immune Enhancement protocol for other suggestions).Overlooked Drugs
Cimetidine, sold under the brand name Tagamet, is used to suppress excess stomach acid production. A side benefit to cimetidine is that it inhibits T-suppressor cells from prematurely shutting off an immune attack against certain viruses. Clinical studies show that cimetidine dramatically shortens the duration of herpes simplex and herpes zoster outbreaks. Cimetidine can be purchased over-the-counter in drug stores, and those infected with viral meningitis may consider taking 200 mg of cimetidine three times a day and 400 mg at bedtime to duplicate successful studies.
Ribavirin is sold in the United States as a prescription drug under the name Rebetol. Ribavarin is a broad-spectrum antiviral drug, and it may be effective against certain viruses that cause meningitis. Suggested dose during viral attacks is 800 to 1200 mg a day taken in divided doses. Those with anemia may not be able to take ribavirin.SUMMARY
Mollaret's meningitis is a poorly understood and rare disorder, the cause of which remains obscure. Typically, a physician's diagnosis of the disease is made by exclusion. The course of the disease, albeit protracted in some patients, is generally benign. Early recognition of this disorder and a patient's own self-care in maintaining optimum health may help reduce recurrence of the disease. However, sudden onset of viral meningitis can occur in a seemingly healthy person with few warning symptoms. The following supplements are recommended to help boost overall immunity and help with pain:
1. Take Life Extension Mix, 3 tablets 3 times a day.
2. Take 500 mcg-6 mg of melatonin daily at bedtime.
3. Take 25-50 mg of DHEA early in the day (see DHEA precautions in the DHEA Replacement Therapy protocol).
4. Take 6000 mg of vitamin C daily.
5. Take coenzyme Q10, 200 mg daily.
6. Take DL-phenylalanine and tyrosine if needed for chronic pain. Typical doses are to start with 500 mg daily and gradually increase to 1500 mg daily (see the Phenylalanine and Tyrosine Dosing and Precautions protocol).
7. Consider cimetidine, 200 mg 3 times a day and 400 mg at bedtime.
8. Ask your doctor to prescribe ribavirin at the dose of 400 mg 2 to 3 times a day.
9. Apply Inflacin as need for pain.For more information
Contact the National Institute of Neurological Disorders and Stroke, (301) 496-5751.
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