What is Temporal Arteritis?
Temporal Arteritis or Giant Cell Arteritis (GCA) is a rare (5 in every 10,000 people are diagnosed) medical condition in which inflammation and damage of the arteries (blood vessels) that supply blood to the head region occurs. Medium and/or large arteries that branch out from the neck region to supply blood to the temporal area are affected. The inflammation is seen on the inside of the arteries. Headache and loss of vision are the 2 major symptoms of this condition.
Due to the formation of abnormally large sized cells in the walls of the swollen arteries, the condition is named Giant Cell Arteritis. Temporal artery is usually affected. These are 2 in number, one on each side of the head, under the skin, on the sides of the forehead which is called ‘temple’ region. Hence the name Temporal Arteritis!
Causes and Risk Factors:
The actual cause of it is not known, but some factors have been attributed to play a key role in the development of the condition. These include:
- Faulty immune system response – Patient’s immune system attacks his/her own body cells treating them as foreign bodies.
- Regular and high dose of antibiotics – People who have taken high doses of antibiotics or who have been seriously ill with severe infections develop this condition.
- Polymyalgia Rheumatica – Giant Cell Arteritis may develop along with or after the patients have been affected by polymyalgia rheumatic (a condition in which the patient experiences shocking and unbearable pain in the shoulders and hips).
Risk factors include:
- Elderly people above the age of 60 fall victim to this condition.
- Women are more affected than men.
- People with African descent have very slim chances of developing it.
- It may run in families.
Symptoms of Temporal Arteritis:
Several symptoms have been associated with this condition, some of which are vague and some of them common in many other medical conditions. Symptoms include:
- Fever, excessive sweating, feeling ill, pain in the jaws (while chewing or talking) and loss of appetite are the most common symptoms. These are the result of the improper blood flow to the brain and other parts of the body.
- Headache – It develops suddenly or gradually over a couple of days. The patient may either experience it on one-side or on both the sides of the head. The pain is specifically felt in the sides and front of the head.
- Visible scalp tenderness – The patient can feel and see the swollen temporal arteries under the skin.
- Vision problems – Patients usually complain of reduced, blurred and double vision (diplopia). These 3 serve as the ‘warning’ signals before the vision is lost. 1 in 5 affected people lose their vision partially or completely. A typical symptom explained by the patients is one of their eyes being covered by a shadow, which can eventually progress to blindness if untreated. The 2nd eye may also be affected within 24 hours or within 1 to 2 weeks.
- Excessive weakness and tiredness.
- More than 5% of the body weight is lost.
Some of the vague symptoms include:
- Mouth sores.
- Joint pain and stiffness.
- Bleeding gums.
- Pain in the facial muscles.
- Hearing impairement.
- Nearly 40% of people have non-specific symptoms such as dry cough, an example of respiratory system problems.
Head examination involves touching the scalp (tender and sensitive) and looking for the swollen artery on one side. Although tests such as liver function tests, blood tests that determine hemoglobin content and erythrocyte sedimentation rate (detects the presence of inflammation) are done, only a biopsy of the affected artery’s tissue confirms the diagnosis.
Complications If Temporal Arteritis Is Left Untreated:
If the condition is not treated immediately and in a proper manner, the following complications may possibly occur. These include:
- Eye muscle weakness or sudden loss of vision.
- Damage of other blood vessels in the body.
- Patients with Giant Cell Arteritis may develop aneurysms (ballooning of blood vessels).
Treatment for Temporal Arteritis:
Because of the rarity of the condition, not many people are aware of it and its symptoms. Moreover, the vague symptoms may mislead a patient to treat them as normal which could delay the process of seeking doctor’s advice and required treatment. Symptoms should be considered seriously which if neglected may lead to more serious complications such as stroke and permanent blindness. The main aim of treating this condition is to decrease tissue damage that may occur due to improper flow of blood. Treatment options include:
- Oral corticosteroids – Patients are advised to begin the intake of these, even before the biopsy is done. Although, most of them feel better within a few days after taking these drugs, they need to be taken on a regular basis for 1 to 2 years. The dosage is gradually reduced. Corticosteroids if taken for longer periods tend to thin the bones making them vulnerable for fractures. Therefore, the following tips should be implemented on a daily basis.
- Avoid excess alcohol intake and smoking.
- Bone health should be monitored on a regular basis through Bone Mineral Density (BMD) Test or DEXA scan.
- Vitamin D and calcium supplements should be taken on doctor’s advice.
- Exercise regularly.
- Aspirin is a recommended drug.
Temporal Arteritis cannot be prevented. All one can do is, if you have elderly people at home whose age is above 60, make sure to take get their eye examination done on a frequent basis.