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Temporal Arteritis
Temporal arteritis, also known
as giant cell arteritis, is an inflammatory condition affecting the
medium-sized blood vessels that supply the head, eyes, and optic nerves.
The disease usually affects those over 60 years of age and causes the
vessels in the temple and scalp to become swollen and tender. Women are
approximately 4 times more likely to suffer from this disease then men.
The
major concern with temporal arteritis is vision loss, although if
allowed to progress, it may affect arteries in other areas of the body.
This condition is potentially vision threatening, however, if treated
promptly, permanent vision loss can be prevented. Vision is threatened
when the inflamed arteries obstruct blood flow to the eyes and optic
nerve If untreated, permanent vision loss can occur from oxygen
deprivation to the retina and optic nerve.
SIGNS AND
SYMPTOMS
Patients with temporal arteritis usually notice visual
symptoms in one eye at first, but as many as 50% may notice symptoms in
the fellow eye within days if the condition is untreated.
•Headache
•Tenderness of scalp (combing hair may be painful)
•Pain in temple area (may be excruciating)
•Transient blurred vision
•Loss of appetite
•Fever
•Fatigue
•Depression
•Drooping
lid
•Double vision
•Sore neck
•Jaw soreness, when
chewing food
DETECTION AND DIAGNOSIS
When temporal arteritis is
suspected, the doctor will order blood tests including a erythrocyte
(red blood cell) sedimentation rate (ESR) and C-reactive protein test.
The ESR test measures the time it takes for the erythrocytes to collect
in the bottom of a test tube. The sediment layer of erythrocytes is
measured in millimeters and recorded. An abnormally high ESR is
indicative of active inflammation.
C-reactive protein is produced
in the liver. This protein is released when the body responds to an
injury or any other event that signals inflammation. C-reactive protein
is measured with a blood test.
A biopsy of the temporal artery is
usually recommended. The procedure is performed with local anesthesia. A
small section of the temporal artery is removed and examined under
magnification for inflammatory cells. This test allows doctors to
definitively diagnose temporal arteritis.
TREATMENT
The
ophthalmologist often works in conjunction with the patient's internist
to treat this disease. The primary treatment for the disease is oral
steroid medication to reduce the inflammatory process. Most patients
notice an improvement in their symptoms within several days. In some
cases, a long-term maintenance dosage of the steroid is required.
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