Temporal arteritis

Giant cell arteritis (cranial or temporal arteritis) is an inflammatory condition that may affect any of the large arteries, especially the temporal and occipital arteries. The thickened temporal arteries may be tender and non-pulsatile, with erythema and oedema of the overlying skin. Early treatment with high-dose corticosteroids such as prednisolone is essential and should be continued for a minimum of 2-3 years at a reduced dose. 

The autoimmune rheumatic diseases consists of Rheumatoid Arthritis (RA), Spondylarthritis (SpA), Systemic Lupus Erythematosus (SLE), Polymyositis, Dermatomyositis, Polymyalgia Rheumatica, Acute Temporal Arteritis, Giant Cell Arteritis, Behcet s Disease, Sjorgren s Syndrome, Felty s Syndrome and Mixed Connective Tissue Disease (MCTD). Spondylarthritis (SpA) can be subdivided in Reactive Arthritis (ReA), Ankylosing Spondylitis (AS), Psoriatic Arthritis (PsA), Arthritis associated with the inflammatory bowel diseases are Crohn s disease and Ulcerative Colitis (IBD), Undifferentiated SpA (UspA) and Sacro-ilitis, Juvenile SpA and Acute Anterior Uveitis (AAU). 

Collagen-vascular disorders Giant cell arteritis, lupus erythematosus, mixed connective tissue syndromes, polymyositis, polymyalgia rheumatica, rheumatoid arthritis, temporal arteritis... 

The effectiveness of immunosuppressive drugs in autoimmune disorders varies widely. Nonetheless, with immunosuppressive therapy, remissions can be obtained in many instances of autoimmune hemolytic anemia, idiopathic thrombocytopenic purpura, type 1 diabetes, Hashimoto s thyroiditis, and temporal arteritis. Improvement is also often seen in patients with systemic lupus erythematosus, acute glomerulonephritis, acquired factor VIII inhibitors (antibodies), rheumatoid arthritis, inflammatory myopathy, scleroderma, and certain other autoimmune states. 

Healey JH, Paget SA, Williams-Russo P, Szatrowski TP, Schneider R, Spiera H, Mitnick H, Ales K, Schwartzberg P. A randomized controlled trial of salmon calcitonin to prevent bone loss in corticosteroid-treated temporal arteritis and polymyalgia rheumatica. Calcif Tissue Int 1996 58(2) 73-80. 

Hedderwick SA, Bonilla HF, Bradley SF, Kauffman CA. Opportunistic infections in patients with temporal arteritis treated with corticosteroids. J Am Geriatr Soc 1997 45(3) 334-7. 

Temporal artery biopsy may be required in suspected temporal arteritis (Ch. 6). 

Fever, malaise, raised ESR, suspected malignancy, temporal arteritis... 

Erythrocyte sedimentation rate Temporal arteritis may cause strokes and cognitive impairment... 

Retinal vasculitis Optic nerve Optic neuritis Temporal arteritis Olobe... 

Skorin L, Larsen K, Eggers D.Temporal arteritis. Contemp Optom 2006 4 1-8. 

Intermittent cyclical etidronate prevented bone loss induced by prednisone in 10 postmenopausal women with temporal arteritis (SEDA-19, 378) (213). Cyclical etidronate (400 mg/day for 2 weeks every 3 months)... 

Temporal arteritis is inflammation of the temporal artery running down the side of the head just in front of the ear. It occurs almost exclusively in elderly people. There is severe unilateral pain, and the area of the temple is inflamed and tender to the touch. There may be associated jaw pain and generalised rheumatic pains. Refer immediately to a doctor. 

You may have never heard of temporal arteritis, but if you ever get it, you ll never forget the experience. It s characterized by severe pain and tenderness to touch at the main superficial artery of the temple. If it is not diagnosed promptly, it can lead to blindness. 

M.G., a 71-year-old woman, developed temporal arteritis in 1960. She suffered for years before the condition was properly diagnosed. Fortunately, she did not go blind, and with cortisone treatment, she got relief. 

Dr. Farr recommended a trial of H202 therapy, because peroxide had proven of value in many inflammatory processes such as pneumonia and asthma. Temporal arteritis is an inflammation of the temporal artery, so, he reasoned, H202 should be of value. 

Epperly TD, Moore KE, Hatrover JD. Polymyalgia rheumatica and temporal arteritis. Am Fam Phys 2000 62 789-796, 801. 

Angioedema and urticaria Insect venom allergy Serum sickness Some drug allergies Transplantation rejection Cardiovascular Diseases Giant cell arteritis Myocarditis Pericarditis Temporal arteritis... 

Inflammatory conditions Primary angiitis Systemic lupus erythematosus Temporal arteritis Takayasu s arteritis... 

Head Soft tissue injury Tender, thickened, or pulseless temporal artery Obliteration of flow through the trochlear artery with compression of the preauricular or supraorbital vessels Anhidrosis Tongue laceration Head trauma Temporal arteritis ICA occlusion or severe stenosis with retrograde ophthalmic flow CCA dissection with damage to sympathetic fibers or brainstem stroke with interruption of sympathetic tract Consider seizure as the cause of the neurologic deterioration... 

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