DIAGNOSIS AND MANAGEMENT OF TEMPORAL ARTERITIS - A REVIEW AND CASE-REPORT

Temporal arteritis is an insidious disease which, if not recognized an d treated with high-dosage oral prednisone or intravenous prednisolone , can result in unilateral or even total blindness due to anterior isc hemic optic neuropathy (AION) or closure of the central artery of the retina. Unfortunately, the symptoms and clinical signs of temporal art eritis mimic those of a number of other conditions including angle-clo sure glaucoma, hypertension, migraine, trigeminal neuralgia, temporoma ndibular joint syndrome, carotid artery occlusive disease, Foster-Kenn edy syndrome, and nonarteritic AION. When a patient complains of a sev ere pain in the temporal region, along with scalp tenderness and a fee ling of malaise or depression-with or without episodes of transient lo ss of vision-he or she should be referred for a diagnostic work-up whi ch includes an erythrocyte sedimentation rate and a temporal artery bi opsy. We present here a review of the recent literature concerning tem poral arteritis, followed by a report of an unusual case in which high -dosage prednisone therapy was effective in relieving the patient's sy mptoms and lowering the sedimentation rate in spite of a negative temp oral artery biopsy.