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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

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