A real pain in the neck (and head): an intro to temporal arteritis

Temporal arteritis, also known as giant cell arteritis (GCA), is a disease where the larger blood vessels of the head, neck, and arms become inflamed, causing a blockage and interrupting blood flow. Temporal arteritis is closely related to a similar condition called polymyalgia rheumatica -- to 20 per cent of people with polymyalgia rheumatica may develop temporal arteritis if the former condition is left unaddressed. Esteemed rheumatologist in East Sussex, Dr Sathianathan Panthakalam, tackles frequent questions with this perfect primer to the potentially dangerous condition.

Who does temporal arteritis affect?

Those above the age of 50 are the most susceptible to this disease, and most diagnoses are made in patients between the ages of 70 and 80. Women are more likely to develop it than men, and more common in those of European descent than in any other ethnic background. It is not yet known what causes the disease, but it is possible that it is an autoimmune condition and may be linked to genetic and environmental factors. Because it is rare in people under 50 years of age, it is also thought that its onset is related to ageing.

What are the symptoms of temporal arteritis?

Earlier symptoms of temporal arteritis can appear to be flu-like, such as fever, night sweats, lack of appetite, and fatigue. Because the symptoms are not obvious, treatment specific to this disease might not be sought in its initial stages. After weeks or months, more symptoms will emerge, such as

• headaches, scalp tension and tenderness, ranging from moderate to severe
• jaw soreness, especially whilst eating
• deterioration of vision, due to lack of blood flow to the eye. This can manifest as double, blurry, or blackening vision, or as periods of sight loss
• feelings of dizziness and disorientation when engaged in activity.
• Unintentional weight loss

At the worst stages of the disease, patients may experience strokes, heart attacks, or become permanently blinded, which is why it is important to get treated for temporal arteritis as soon as possible.

How is temporal arteritis diagnosed?

If you suspect you are exhibiting signs of temporal arteritis, you should consult a doctor about getting a formal examination. Your current symptoms, medical history, and a physical examination should all be held in consideration. The first stage of diagnosing can be as simple as a touch to the head – the doctor should note that the temporal artery is swollen and that the area is tender to the touch. The next stage would be a biopsy of the temporal artery, where a section of tissue is taken from around the temple and examined to see if the cells in the arterial walls are unusual.

How is temporal arteritis treated?

The most effective and common treatment for temporal arteritis is a prescription of corticosteroids, which may necessitate a lengthy routine of taking the drug over the course of several years to keep the inflammation in check. Your doctor will advise on when and how much you will need, as it will vary from case to case. Some patients will have to adopt a routine of lower doses of the medication for the rest of their lives. If signs point to the disease as being a result of an autoimmune reaction, then immunosuppressants like methotrexate may be prescribed.

For any concerns regarding temporal arteritis or other rheumatological conditions, Dr Sathianathan Panthakalam is available for appointment via his Top Doctors Profile.