Most cases of temporal arteritis occur in people older than 50, but this doesn’t mean a younger person cannot ever develop this condition.
“Temporal arteritis or giant cell arteritis is a systemic inflammation of blood vessels,” says Natasha Fuksina, MD, an internal and integrative medicine specialist who combines traditional, integrative and functional medicine to restore health and function.
Dr. Fuksina explains, “Commonly it affects the blood vessels around the temples, thus giving rise to the name temporal arteritis.
“The cause is unknown but represents an attack of the immune system, which can lead to potentially serious complications.
“Common symptoms are severe headaches, scalp pain, visual changes, fevers, malaise.”
Additional Symptoms (no particular order)
• Jaw pain after chewing
• Facial pain
• Throat pain
• Tongue pain
• Joint pain (shoulder, hips)
• Arm pain from exercise
• Patients may have many or only a few of these symptoms.
The diagnosis can be challenging due to the uncommon occurrence of temporal arteritis and the fact that its symptoms can mimic TMJ disorder and other conditions.
“Serious complications are blindness, aortic aneurysm (bulging of the weakened aortic wall), and rarely, stroke,” says Dr. Fuksina.
The term “giant cell” arises from the fact that under a microscope, the cells of inflamed temporal arteries appear pretty big.
The average age of temporal arteritis onset is 72, with women being affected two to three times more than are men.
Cases of people under 50 with temporal arteritis or giant cell arteritis have been reported in medical literature.
The Journal of Vascular Surgery (May 2006) reports the case of a 17-year-old boy, and the journal Joint, Bone, Spine (May 2013) reports the case of two men, 31 and 40.
“Temporal arteritis can co-exist with polymyalgia rheumatica, another inflammatory disease characterized by stiffness and pain in the neck and shoulders, in 50% of the cases,” says Dr. Fuksina.
“Temporal blood vessel biopsy is the gold standard for diagnosis. Treatment is usually high dose steroids such as prednisone.”
Other features that suggest (though don’t confirm) giant cell arteritis are:
• Elevated erythrocyte sedimentation rate
• Mild anemia
NOTE: In a small number of cases, an afflicted individual’s temporal artery sample will not show inflammation.
However, chances are high that a biopsy of the temporal artery on the other side will be positive.
Treatment
• The prednisone is taken daily, 40-60 mg.
• Most patients improve quickly.
• If blindness has already occurred prior to treatment, it’s usually permanent.
• Over time in nearly all cases, the prednisone dose can be lowered.
• Most patients will need the medication for one to two years.
Dr. Fuksina
