Temporal arteritis is a swelling or inflammation that involves the temporal artery. The temporal artery runs over the temple, along the area to the outside of the eye. In extreme or untreated cases, temporal arteritis can lead to blindness.
Another condition, giant cell arteritis (GCA) is used to describe inflammation that can occur in the arteries of the head, neck, upper body, and arms. When GCA involves mainly the temporal artery, it can be referred to as temporal arteritis. Vasculitis is the more general term for swelling or inflammation of blood vessels anywhere in the body.
Causes
The cause of temporal arteritis is not known. It may result from an immune response in the body.
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition. Your risk of temporal arteritis increases if:
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Your age is 50 or older
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Your race is white, especially of Scandinavian or northern European descent
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You live in northern latitudes (as opposed to living in southern latitudes)
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Your sex is female
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You have a family member with temporal arteritis
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You have polymyalgia rheumatica, a condition characterized by stiffness and pain in muscles of the neck, shoulders, lower back, hips, and thighs
Symptoms
Symptoms may include:
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Headaches that are usually localized and one-sided
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Fever or flu-like symptoms
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Pain when chewing
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Pain in the jaw or tongue
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Scalp pain or tenderness over the temporal artery
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Anemia
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Fatigue
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Loss of appetite and weight loss
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Vision loss
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Sweats
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Aches in the joints or muscles
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam.
Diagnosis is based on the occurrence of certain factors, including:
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Age: 50 or older
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New localized headache
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Temporal artery tenderness or decreased temporal artery pulse
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Sedimentation rate of 50 mm/hour or greater
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Abnormal temporal artery biopsy
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Anemia
Tests may include:
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Blood tests, including a sedimentation rate, hemoglobin, or hematocrit
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Biopsy–removal of a sample of the temporal artery for testing
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Retinal exam
Treatment
Treatment may include:
Corticosteroid Therapy
Corticosteroid therapy is used to decrease the swelling, inflammation, and risk of blindness. High doses of prednisone are often prescribed initially and then tapered off. Therapy is often continued for several years. Methotrexate may be used as s steroid sparing agent.
Calcium and Vitamin D Supplementation
You may be advised to take supplements of calcium and vitamin D to counteract the effects of long-term corticosteroid use on bone. Prolonged use of corticosteroids has potential side effects that include may include osteoporosis, diabetes, cataracts, and stomach irritation.
Prevention
There is no known way to prevent temporal arteritis.
RESOURCES:
American Academy of Family Physicians
http://www.aafp.org
Arthritis Foundation
http://www.arthritis.org
National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov
References:
American Academy of Family Physicians website. Available at: http://www.aafp.org.
Nat Clin Pract Rheumatol. 2006;2(8):443-451.
National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov.
Parikh M, Miller NR, Lee AG, et al. Prevalence of a normal c-reactive protein with an elevated erythrocyte sedimentation rate in biopsy-proven giant cell arteritis. Ophthalmology. 2006;113(10):1842-1845.
University of Southern California Department of Neurosurgery website. Available at: http://archsurg.ama-assn.org/cgi/content/full/139/11/1146.
