When I experienced a sudden and severe headache around my temples I wasn't too worried until I started to have blurring of my vision. I got such a fright I went straight into A&E where I was told it was most likely temporal arteritis. Can you tell me what this is?
Temporal arteritis is a chronic inflammation of large arteries, most usually of the temporal artery on the side of the scalp.
The condition, the cause of which remains unknown, is estimated to affect about one in 1,000 individuals. Sufferers are usually over 50, with women affected slightly more often than men.
Symptoms will vary but when the large arteries of the head are involved, sudden onset of headache typically develops at the temples or in the back of the head. Sufferers often describe a sensation of the blood vessels feeling swollen and the scalp can feel painful, even to light touch or hair brushing.
Eye problems including blurred or double vision, large blind spots or blindness in one eye can develop. In many cases, vision returns to normal but in some there is a risk of permanent blindness occurring if the blood supply to the optic nerve has been blocked.
The tongue, the muscles used to chew and the jaw can also be painful when talking or eating. Severe pain in the neck and shoulders can also occur. The condition can also occur in those diagnosed with polymyalgia rheumatica, another inflammatory condition that can cause severe pain, and stiffness in the muscles of the neck, shoulders and hips.
I've been given an appointment to have a biopsy of my temporal artery done. Can you tell me what's involved in this test?
Although a diagnosis of temporal arteritis can be made on a physical examination and the history of symptoms, a definitive diagnosis of the condition is usually made by means of a biopsy of the blood vessel. After a local anaesthetic is injected into the temple area, a shallow incision is made into the temporal artery. A small section of the artery is then removed for microscopic examination. The incision is then closed. Blood tests can also be used to detect evidence of inflammation.
Why, when a definitive diagnosis has not yet been made, was I put on treatment?
Because temporal arteritis can cause permanent blindness in about 20 per cent of untreated cases, treatment of suspected cases is initiated as soon as the condition is suspected. Typically, corticosteroids are used at high doses to control the inflammation of the blood vessels. The dosage is then slowly reduced once the person shows signs of improvement. However, some will require prolonged treatment with steroids.