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Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions about temporal arteritis:

1. Could my headaches, facial pain or other symptoms be due to temporal arteritis?
2. What else could be causing my symptoms?
3. What tests for temporal arteritis might I undergo, and what do they involve? Is a biopsy necessary?
4. How can temporal arteritis affect other conditions I may have?
5. How likely is it that I also have polymyalgia rheumatica?
6. Has my temporal arteritis impaired my vision? Is this change temporary or permanent?
7. How frequently should I see an ophthalmologist for eye exams?
8. How long will I likely need to remain on corticosteroids? What are their side effects? Can short-term intravenous corticosteroids reduce or eliminate my need for long-term oral corticosteroids?
9. Should I alter my diet?
10. Which exercises should I consider?
11. How long will it likely take to resolve my temporal arteritis? What are the chances I’ll experience a relapse?

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Researchers are investigating many factors of temporal arteritis. The roles of genetic predisposition, immune system abnormalities and environmental factors on the development of temporal arteritis are being studied. Research is also under way to evaluate the pathology of the disease, explore treatments, and study why temporal arteritis often occurs with polymyalgia rheumatica. A new mouse model funded by the National Eye Institute is examining the interactions between the immune system and blood vessels in the damage of tissues.

Recent small-scale research indicates that short-term intravenous corticosteroid therapy may treat temporal arteritis or decrease the need for long-term oral corticosteroids. If additional trials confirm these findings, patients may be able to avoid the risks of long-term corticosteroid use, which can include diabetes, osteoporosis and fractures.

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Though there is no known means of preventing or curing temporal arteritis, the disease typically runs a self-limited course over several months to several years. Early treatment is important for good results. When it is properly treated, temporal arteritis is not threatening in most patients. However, if left untreated it may lead to serious complications, such as blindness, stroke or an aortic aneurysm. In a small number of patients, these problems can develop even when temporal arteritis is diagnosed and treated.

The most common of these complications is impaired vision or blindness. To reduce this risk, patients are typically referred to an ophthalmologist to watch for any signs of threatening blindness, such as involvement of arteries that supply the eyes with blood.

The most commonly prescribed medications for temporal arteritis are oral corticosteroids. These medications are started immediately in high doses to prevent blindness. In some cases, corticosteroid therapy may be initiated before diagnosis is confirmed with a temporal artery biopsy.

Although patients usually begin feeling better in just a few day, they typically continue taking a high dose for one month. As symptoms disappear and the risk of blindness is removed, the dose is gradually reduced to the lowest effective dose. Dosage must be reduced gradually because these drugs alter the body’s natural production of certain hormones. Stopping the medication suddenly can make a person very sick.

Most people can stop taking corticosteroids in six months to two years, but treatment is occasionally prolonged beyond this. Possible side effects of long-term use of corticosteroids include osteoporosis, fractures, diabetes, glaucoma, cataracts and high blood pressure. All side effects should be reported to a physician. A physician may recommend that patients on corticosteroids take supplements of calcium and vitamin D to reduce the risk of osteoporosis. Recent research suggests that high-dose intravenous corticosteroid therapy for only a few days may resolve temporal arteritis or reduce long-term need for oral corticosteroids.

Although the symptoms of temporal arteritis respond well to proper medication and treatment nearly eliminates the risk of serious complications, patients may wish to take certain other factors into consideration:

* Exercise. Important to maintain joint flexibility and muscle strength and function. Exercise may be particularly useful in dealing with possible drug-induced side effects, such as increased glucose (blood sugar) and decreased bone density. Low-impact exercises (e.g., swimming, walking) and stretching are usually emphasized. Patients should consult their physician before starting an exercise program. It is important to start slowly and work up gradually, particularly if the patient is not used to regular exercise.

* Nutrition. May help prevent such potential problems as thinning bones, high blood pressure and diabetes, which are associated with corticosteroid use. Proper nutrition can also strengthen the immune system. Fresh fruits and vegetables, whole grains and lean meats and fish are emphasized, as well as foods with plenty of calcium and vitamin D. Salt, sugar and alcohol are limited. Tobacco should be avoided.

When properly treated, temporal arteritis seldom recurs.

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Signs and symptoms of temporal arteritis include:

* Pain and tenderness. A dull, persistent pain in the temples is the most common symptom of temporal arteritis. This pain is usually worsened by chewing. The face and scalp may also be painful and tender, and the pain may extend to the jaw and tongue. In addition to facial pain, a patient may experience ear pain or dental pain. Sore throats are common. In some cases, the muscles may ache.

* Headache. Dull headaches occur in about two-thirds of all temporal arteritis cases. These may occur on one or both sides of the head and may be moderate to severe. Headaches may be localized to the temporal regions or may be more generalized. They are typically chronic and may get worse over time.  Most patients suffering temporal arteritis report that the headache associated with it is markedly different from other headaches they have had.

* Jaw claudication (pain when chewing). The chewing (masticatory) muscles may become weak and painful. This occurs in about half of temporal arteritis cases.

* Abnormal temporal arteries. In about half of all cases of temporal arteritis, the temporal arteries develop a knobby thickening and become firm. They are generally tender to touch, and it may be difficult to feel a pulse within them.

* Vision problems. Blurred or double vision is a frequent complaint in people with temporal arteritis. Patients may experience eye pain, but the visual impairment can be painless. Sudden loss of vision, usually in only one eye but sometimes in both, is a less common but serious risk. The loss of vision may be transient. According to the Arthritis Foundation, this blindness occurs in 10 to 15 percent of cases.

* Fever. A fever may accompany temporal arteritis. Although typically low-grade, it may mimic the fever of an infection, such as pneumonia.

* Fatigue. Many temporal arteritis patients suffer from general fatigue.

* Weight loss. Temporal arteritis patients may experience a loss of weight.

* Upper respiratory complaints. A dry cough and moderate to severe sore throat occur in some cases.

* Horner’s syndrome. This involves a drooping upper eyelid, pupil contraction and receding eyeball. It may occur with temporal arteritis.

* Chest pain. Rarely, temporal arteritis is accompanied by chest pain, which suggests cardiovascular involvement.

Symptoms can also be due to other conditions, such as another form of vasculitis, Lyme disease, systemic lupus erythematosus, rheumatoid arthritis, amyloidosis (abnormal deposit of proteins in tissues) or TMJ disorder. A biopsy is used to identify temporal arteritis.

In many cases, temporal arteritis patients also suffer from pain and stiffness in the neck, arms and hips, particularly in the morning. This is a symptom of polymyalgia rheumatica, a condition that commonly occurs with temporal arteritis.

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Temporal arteritis is a type of vasculopathy (disease of the blood vessels) characterized by chronic inflammation of the lining of large arteries, particularly the temporal arteries, located on each side of the head. Temporal arteritis is also called giant cell arteritis because the cells lining the arteries become enlarged.  The cause of temporal arteritis is unknown.

Arteries carry oxygen- and nutrient-rich blood to the body. The temporal arteries are the large arteries that branch off the carotid arteries in the neck and feed the head, eyes and optic nerves.

Although the arteries of the head are most commonly affected, those in the neck, arms and upper body (including the aorta and its branches) may also be affected. The temporal arteries on one or both sides of the head may be affected.

Inflammation and swelling causes the affected arteries to narrow, which reduces blood flow. There can also be death (necrosis) of arterial tissue. The artery may close entirely (occlude) because of severe inflammation or the formation of a blood clot that clogs the artery. In rare cases, an artery will weaken and bulge instead of swell, forming an aneurysm.

Without oxygen, cells begin to die. In severe cases, temporal arteritis can lead to permanent blindness in one or both eyes due to a lack of blood flow. Temporal arteritis is considered the prime ophthalmic emergency because prompt treatment can prevent blindness.

Other serious risks are much rarer. The swelling or blockage of certain arteries in the head may interrupt blood flow to the brain, resulting in a stroke. In late, untreated temporal arteritis, an aneurysm may form in the aortic artery. This aneurysm may burst and cause massive, life-threatening internal bleeding.

However, when temporal arteritis is treated it often resolves within a few months or years. It is not associated with increased mortality.

Temporal arteritis almost exclusively affects individuals over the age of 50. Women are affected twice as often as men, and the condition is most common in individuals of Northern European descent. Temporal arteritis is quite common. It is the most common type of vasculitis (inflammation of the blood vessels) in white Americans. According to the National Institutes of Health, about 200 per 100,000 Americans over age 50 develop temporal arteritis.

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