Temporal Arteritis

Introduction

• Older, mostly women

• High index of suspicion to detect this early

• Any history of headache in the elderly is a concern and symptoms can often be variable and vague

• Urgent treatment with steroids

Note: Always investigate headaches in the elderly

Assessment

Presentation:

• Jaw claudication (increasing pain with chewing)

• Unilateral pain - often vague in description

• Anxiety

• Visual disturbances (indicative of advanced disease) - ensure full eye examination is performed

Examination

• Examination may be normal

• Eye examination - hemianopia?

• Tenderness over the temporal artery superior and anterior to the pinna of the ear

Investigations

• The hallmark of diagnosis is an elevated ESR, generally over 75 mm hr

Management

• Immediate referral and high dose steroids

Disposition

• Admission under neurology/physician team