What is Temporal Arteritis?
Temporal arteritis is a type of vasculitis or blood vessel inflammation. In this condition, there is swelling and thickening of the lining of the artery under the skin of the temple or side of the head.
Temporal arteritis is an autoimmune condition that occurs when healthy cells are attacked by the immune system by mistake.
Temporal arteritis is also known as giant cell arteritis as it not only affects the temporal arteries but also the other blood vessels including the thoracic aorta and its branches.(1) It is named a giant cell because the biopsies show enlarged cells on the microscope.
Temporal arteritis is common after the age of 50 years.(2) Also, it is more likely to affect women than men.(3)
Causes of Temporal Arteritis
The exact cause of temporal arteritis is not known but it is thought to be an autoimmune condition in which the immune cells of the body mistakenly attack the healthy cells in the arteries, which leads to inflammation.
Giant cell lesions form as the blood vessel lining gets inflamed and the numerous immune cells or the white blood cells fuse together.
The risk factors of temporal arteritis include:
- Age: The chances of suffering from temporal arteritis increase as a person age
- Seasonal factors
- Genetic factor
- Exposure to toxins and viruses
- Suffering from a health condition related to vasculitis or inflammation
People from northern European backgrounds are more at risk of suffering from temporal arteritis.(6)
Symptoms of Temporal Arteritis
The main symptom of temporal arteritis is a severe, persistent, and throbbing headache. It occurs usually on the side or front of the head.
Other symptoms of temporal arteritis include:
- Tenderness in temples
- Blurry or double vision
- Pain in the tongue
- Mouth-related pain
- Tenderness and swelling on the top of the head
Few people also experience flu-like feelings, loss of appetite, weight loss, sweating, fever and malaise.(2)
Complications of Temporal Arteritis
Loss of vision is the most common complication of temporal arteritis. It occurs as vasculitis affects the artery that supplies the eye and damages it.
A person with damage to the artery supplying the eye shows the following symptoms:
- Blind spots
- Drooping eyelid
- Blurred vision
- Double vision
Vision loss is seen affecting 14-20 percent of people with temporal arteritis.(4)
Other complications include excessive swelling of arteries. It is also been linked with a higher risk of heart attack, stroke or aortic aneurysm.
Diagnosis and Treatment of Temporal Arteritis
If any symptom indicates temporal arteritis, a doctor should be consulted. The doctor takes the medical history and does a physical examination. A few tests are ordered to confirm the diagnosis:
- Blood test to check the erythrocyte sedimentation rate
- Ultrasound to check for temporal artery abnormalities
- Biopsy of the artery wall is done to look for inflammation of the artery
- Due to the risk of vision loss, treatment begins before the biopsy result.
In the treatment, corticosteroids are given and are recommended to start immediately and aggressively. People with vision problems are given steroids in higher doses. The doses are decreased after a month. Some people taking corticosteroids experience side effects.
Actemra is another drug that is used to treat this condition. It affects the immune system. The side effects related to the drug include:
- Stomach tears
- Changes in blood composition
- High risk of cancer
- Allergic reactions
- Nervous system complications
If someone experience symptoms such as upper respiratory infection, headaches, high blood pressure and reaction at the injection site, a doctor should be consulted immediately.
The outlook of temporal arteritis is poor if no treatment is given. The symptoms start improving a day or two after starting the treatment.(5) The time taken for recovery varies with people.
People with temporal arteritis have higher chances of aortic aneurysms and cardiovascular disease. Also, it increases the risk of death in people suffering from it. It is therefore important to attend the follow-up appointment as ignorance can lead to complications.
