Temporal ArteritisSymptomsThe symptoms of temporal arteritis (also known as giant cell arteritis) are persistent, daily or near-daily headaches, often with tenderness around the face or temple on one or both sides. Patients are typically 50 years or older, more often women, and may complain of pain and fatigue while chewing (jaw claudication) and vision loss. Vision loss can be sudden but transient, usually affecting only one eye (initially). Vision loss can be permanent though, and can eventually affect both eyes, this being the most feared and serious consequence of this disease. Patients may also complain of, or have a history of, muscle pain and tenderness throughout the body (due to polymyalgia rheumatica ). What is temporal arteritis?This is inflammation of the temporal artery, which can involve also inflammation of multiple arteries in the neck or even in the chest (aorta). This disease is idiopathic, meaning it is not clear why the disease occurs.How is it diagnosed?The diagnosis is suspected based on the symptoms. Patient's may also have tenderness at the temple on exam, or portions of the temporal artery may actually feel hard to the touch, or the pulse of the temporal artery may be difficult to detect. Physicians will often send a blood test (ESR) which is a non-specific measure of inflammation in the body. Unfortunately the ESR result is often elevated due to other causes (infection, joint inflammation, etc..) and so it must either be very high (indicating a patient has the diagnosis) or normal (indicating that the diagnosis is unlikely) for it to be useful. Definitive diagnosis requires biopsy of the temporal artery. If steroids are initiated, the biopsy should be performed no later than one week, or else the inflammation may be reduced and the biopsy read (falsely) as normal.What are potential complications of this disease?Permanent vision loss in one or both eyes is among the most feared complications of this disease. To prevent this outcome, the disease must be identified early and treatment initiated right away. Another (rare) complication is a stroke as a result of portions of inflammed blood vessels traveling into the brain. Patients are also at risk of developing general muscle pain ( polymyalgia rheumatica ).How is it treated?Temporal arteritis is treated with oral steroids. These have the effect of stopping the inflammation and are rapidly helpful. The duration of therapy is variable but can be as long as 1 or 2 years. Steroids are generally tapered slowly, with the patient and physician observing for any signs of disease recurrence.Return from TEMPORAL ARTERITIS to WORRISOME HEADACHE SYMPTOMS
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